Individual
JOANI L JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-6012
(423) 778-6958
Mailing address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-6012
(423) 778-6958
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24883
TN
Other
Enumeration date
02/14/2006
Last updated
11/18/2008
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