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Individual

JACKIE JERLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10140 DEER RUN FARMS RD, FORT MYERS, FL 33966-1045
(239) 333-1606
(239) 275-0577
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 333-1606
(239) 275-0577

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/29/2012
Last updated
08/29/2012
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