Individual
DR. PENNY TRONELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1161 HIGHWAY 135 S, SUITE 1, WILLACOOCHEE, GA 31650-7747
(912) 381-0064
(912) 534-6176
Mailing address
PO BOX 1100, WILLACOOCHEE, GA 31650-1100
(912) 381-0064
(912) 534-6176
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008305
GA
Other
Enumeration date
03/28/2008
Last updated
04/22/2008
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