Individual
JESSICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1914 8TH ST, CORALVILLE, IA 52241-1612
(319) 381-3880
Mailing address
1914 8TH ST, CORALVILLE, IA 52241-1612
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21729
IA
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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