Individual
CASEY D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
174 INDUSTRIAL PARK RD, JANE LEW, WV 26378-9785
(304) 884-8237
(304) 884-8924
Mailing address
746 FAIRMONT RD, WESTOVER, WV 26501-4060
(304) 225-5222
(304) 225-5224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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