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Individual

JONI M STRUCKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA C

Contact information

Practice address
850 INDEPENDENCE ROAD, COAL CITY, WV 25823-1595
(304) 469-2905
(304) 683-6906
Mailing address
PO BOX 337, SCARBRO, WV 25917
(304) 465-1378
(304) 469-2981

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01260
WV
363A00000X
Physician Assistant
Primary
454
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810007575
WV
Enumeration date
10/20/2006
Last updated
05/18/2020
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