Individual
CASSANDRA LAVETTE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2806 LONESOME RD, ALBANY, GA 31721-5641
(229) 894-5738
Mailing address
2806 LONESOME RD, ALBANY, GA 31721-5641
(229) 894-5738
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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