Individual
MRS. TORI SHAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
335 N MAIN ST, BARBOURVILLE, KY 40906-1445
(606) 545-7083
Mailing address
924 TRACE BRANCH RD, BARBOURVILLE, KY 40906-7403
(606) 595-0523
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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