Individual
JACK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
60 TURNER LN, SHINNSTON, WV 26431-7112
(304) 641-5207
Mailing address
60 TURNER LN, SHINNSTON, WV 26431-7112
(304) 641-5207
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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