Individual
SHERRELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5441 BALTIMORE NATIONAL PIKE STE 4B, BALTIMORE, MD 21229-2102
(443) 516-7682
Mailing address
10 WOODSTREAM CT, OWINGS MILLS, MD 21117-4062
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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