Individual
JAZZRIEL LE CLARK-CASTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
527 MEDICAL PARK DR STE 205, BRIDGEPORT, WV 26330-9009
(681) 342-3730
Mailing address
527 MEDICAL PARK DR STE 205, BRIDGEPORT, WV 26330-9009
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
107200
WV
Other
Enumeration date
04/19/2024
Last updated
01/17/2025
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