Individual
JEFFREY KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
400 TRACY WAY, CHARLESTON, WV 25311-1280
(304) 720-0205
Mailing address
400 TRACY WAY, CHARLESTON, WV 25311-1280
(302) 720-0205
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20549
WV
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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