Individual
LORI-ANN MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
116 MARKET ST, MANNINGTON, WV 26582-1131
(304) 986-1568
(304) 986-1373
Mailing address
12 HARTMAN PLZ, BUCKHANNON, WV 26201-2230
(304) 473-0531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2846
WV
Other
Enumeration date
11/08/2010
Last updated
05/24/2012
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