Individual
MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 CENTRE POINTE DR, NORTH CHARLESTON, SC 29418-6927
(843) 529-9908
Mailing address
1449 SAINT HUBERT WAY, CHARLESTON, SC 29414-8101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8661
SC
Other
Enumeration date
09/08/2013
Last updated
09/08/2013
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