Individual
ANGEL MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 333-0943
Mailing address
2777 NORTHTOWNE LN APT 2075, RENO, NV 89512-5011
(775) 420-5108
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NV
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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