Individual
JEANETTE DANIELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 1/2 D ST STE 3, SOUTH CHARLESTON, WV 25303-3114
(304) 610-1947
Mailing address
415 1/2 D ST STE 3, SOUTH CHARLESTON, WV 25303-3114
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2012-2933
WV
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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