Individual
JAMES J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 POPPY ST, MCDONOUGH, GA 30253-6452
(334) 650-4010
Mailing address
161 POPPY ST, MCDONOUGH, GA 30253-6452
(334) 650-4010
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014870
GA
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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