Individual
JACOB DAVID WINKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 MACCORKLE AVE SE, CHARLESTON, WV 25304-1045
(800) 995-4682
Mailing address
1501 DELTA DR, CHARLESTON, WV 25387-1638
(916) 837-8153
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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