Individual
AHLEEYAH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
64 MEDICAL CENTER DR, MORGANTOWN, WV 26505-3409
(304) 293-4511
Mailing address
1309 18TH ST, HUNTINGTON, WV 25701-3950
(304) 412-2158
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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