Jackie D Shorter, PAC
NPI #1871676874 in Pineville, West Virginia
Provider Information
- NPI Number
- 1871676874
- Entity Type
- Individual
- Name
- Jackie D Shorter, PAC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- PAC
- Enumeration Date
- Oct 23, 2006
- Last Updated
- Feb 12, 2010
Practice Location
- Address
- 1650 MAIN STREET
- City
- Pineville
- State
- West Virginia
- ZIP Code
- 24874
- Phone
- (304) 732-6735
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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