Individual
JACQUELINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
224 MINOR AVE, NITRO, WV 25143-1290
(304) 437-5245
Mailing address
224 MINOR AVE, NITRO, WV 25143-1290
(304) 437-5245
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2019-3715
WV
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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