Individual
PENNY DENISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
178 PROGRESS WAY, ROCKY FACE, GA 30740-7748
(706) 537-4777
Mailing address
178 PROGRESS WAY, ROCKY FACE, GA 30740-7748
(706) 537-4777
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/26/2024
Last updated
01/31/2024
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