Individual
DR. CODY JAMES JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6087 US HIGHWAY 6, PORTAGE, IN 46368-5046
(219) 759-5811
Mailing address
314 TIMI DR, VALPARAISO, IN 46385-8504
(219) 742-4663
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027744A
IN
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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