Individual
MICHAELA L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C
Contact information
Practice address
105 ASHLAND AVE, CLINTON, SC 29325-2960
(864) 833-7098
Mailing address
3201 WOODHAVEN CT SW, CONYERS, GA 30094-3951
(770) 375-7665
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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