Individual
MRS. CHRISTINE STEVENS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
161 LIBERTY ST, MC CLELLANVILLE, SC 29458-9721
(843) 230-9297
Mailing address
161 LIBERTY ST, MC CLELLANVILLE, SC 29458-9721
(843) 230-9297
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
1600
MT
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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