Individual
JESSICA BALESTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1114 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-2313
(304) 845-0504
Mailing address
29 OAK PARK AVE, WHEELING, WV 26003-5539
(304) 553-5266
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03335091
OH
183500000X
Pharmacist
Primary
RP0009302
WV
Other
Enumeration date
09/27/2020
Last updated
12/07/2020
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