Individual
MS. JESSICA LYNN ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4301 MACCORKLE AVE SE, CHARLESTON, WV 25304-2503
(304) 720-9185
Mailing address
1106 IVYWOOD LN, SOUTH CHARLESTON, WV 25309-1708
(304) 549-8273
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2764
WV
Other
Enumeration date
07/14/2009
Last updated
12/11/2020
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