Individual
JACOB DAVID WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 J D ANDERSON DR, MORGANTOWN, WV 26505-3494
(800) 394-4445
Mailing address
14 EVERGREEN DR, BRIDGEPORT, WV 26330-9266
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
58152
WV
Other
Enumeration date
12/18/2008
Last updated
11/19/2018
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