Individual
JESSICA GLENN TETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 MOUNTAIN PARK DR, FAIRMONT, WV 26554-8992
(304) 816-3687
(304) 816-3737
Mailing address
16 MOUNTAIN PARK DR, FAIRMONT, WV 26554-8992
(304) 816-3687
(304) 816-3737
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
WV
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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