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Individual

JACKIE CARBERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-8230
Mailing address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
10/29/2012
Last updated
10/29/2012
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