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STEPHANIE S JACKSON

>> Contractor >> Other Service Providers

Registrant NPI Number: 1679143747

Individual Registrant:
 STEPHANIE S JACKSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
262 PEBBLE HILL CIR  SYLVESTER, GA 31791-7759 US
Tel: 229-206-2767  Fax: --

Contact information for business:
262 PEBBLE HILL CIR  SYLVESTER, GA 31791-7759 US
Tel: 229-206-2767  Fax: --

Registration Information:
NPI: 1679143747
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171W00000XOther Service Providers
Contractor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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