Individual
KILEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
246 FAYES VALLEY RD, GIVEN, WV 25245-8027
(304) 532-3975
Mailing address
246 FAYES VALLEY RD, GIVEN, WV 25245-8027
(304) 532-3975
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4551
SC
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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