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Individual

BEULAH JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHLEBOTOMIST

Contact information

Practice address
603 PETERS ST, WILDWOOD, FL 34785-3927
(352) 292-6433
Mailing address
PO BOX 1362, WILDWOOD, FL 34785-1362
(352) 292-6433

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary

Other

Enumeration date
12/14/2021
Last updated
12/14/2021
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