Individual
SHAMEEKA KENYON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2102 OXFORD RD, ALBANY, GA 31721-5215
(229) 296-5020
Mailing address
2102 OXFORD RD, ALBANY, GA 31721-5215
(229) 296-5020
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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