Individual
MS. CHERYL R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. S., A.T., C.
Contact information
Practice address
5243 DALEWOOD DR, CROSS LANES, WV 25313-1748
(304) 776-6220
Mailing address
5243 DALEWOOD DR, CROSS LANES, WV 25313-1748
(304) 776-6220
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
F127164
WV
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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