Individual
MS. JACQUELYNN ANNA COPENHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3012 NORTHPOINTE PLZ, MORGANTOWN, WV 26505-3277
(304) 292-2211
Mailing address
3012 NORTHPOINTE PLZ, MORGANTOWN, WV 26505-3277
(304) 292-2211
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2010-2719
WV
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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