Samuel Tackett
NPI #1578329595 in War, West Virginia
Provider Information
- NPI Number
- 1578329595
- Entity Type
- Individual
- Name
- Samuel Tackett
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community Health Worker
- Enumeration Date
- Feb 27, 2024
- Last Updated
- Feb 27, 2024
Practice Location
- Address
- 133 SUSANNA RD
- City
- War
- State
- West Virginia
- ZIP Code
- 24892-9001
- Phone
- (304) 875-2452
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Health Worker |
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