Individual
DR. DANIELLE NICOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3360 SHELBY LN, SUITE 1010, EAST POINT, GA 30344-5744
(404) 344-0274
(404) 344-4581
Mailing address
5370 HIGHWAY 92, STE 410, FAIRBURN, GA 30213-2296
(770) 629-4351
(770) 703-3398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002717
GA
Other
Enumeration date
08/16/2012
Last updated
12/15/2016
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