Individual
MRS. JESSECA LYNN FULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-4444
Mailing address
RR 2 BOX 24A, ELIZABETH, WV 26143-9767
(304) 275-3889
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 001094
WV
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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