SearchWest Virginia374U00000X

Traci Jackson

NPI 1881581452 · on the registry since 2025 · sole proprietor

Practice

Address
180 Jems Ln
Prichard, WV 25555
Phone
(304) 412-1557

Registry record

Primary taxonomy
374U00000X
374U00000X
Sex
Male
Record last updated
2025-06-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in West Virginia