Individual
SHAMEIKA LAQUIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 STURGEON RD, LAWRENCEVILLE, VA 23868-2842
(434) 532-7936
Mailing address
121 STURGEON RD, LAWRENCEVILLE, VA 23868-2842
(434) 532-7936
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T69520650
VA
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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