Individual
JESSICA LYNN SOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
419 BROOKS ST, CHARLESTON, WV 25301-1811
(304) 388-6004
Mailing address
3100 MACCORKLE AVE SE, STE 203, CHARLESTON, WV 25304-1228
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2340
WV
Other
Enumeration date
09/04/2007
Last updated
12/13/2016
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