Individual
JESSICA JO CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1519 MARY LOU RETTON DR, FAIRMONT, WV 26554-2203
(304) 282-5582
Mailing address
1519 MARY LOU RETTON DR, FAIRMONT, WV 26554-2203
(304) 282-5582
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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