Individual
ERIKA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2706 E MAIN ST, MESA, AZ 85213-9227
(480) 644-9037
Mailing address
14260 W WINDROSE DR, SURPRISE, AZ 85379-5546
(269) 350-4165
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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