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Individual

MRS. JESSICA CHRISTINA MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
8610 N NEW BRAUNFELS AVE STE 405, SAN ANTONIO, TX 78217-6358
(210) 804-0193
(210) 610-8782
Mailing address
PO BOX 43, LA COSTE, TX 78039-0043
(210) 627-0781

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
317848
TX

Other

Enumeration date
08/27/2018
Last updated
08/27/2018
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