Individual
JILL ANN SPACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223
(270) 956-0336
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1086080
CO
Other
Enumeration date
05/19/2009
Last updated
06/20/2018
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