Individual
MRS. CHRISTINE FORD-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
3110 CLIFTON SPRINGS RD, #B, DECATUR, GA 30034-4600
(404) 243-9500
(404) 244-2224
Mailing address
3940 CHIMNEY RIDGE CT, ELLENWOOD, GA 30294-1446
(404) 212-0722
(404) 212-0722
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN040867
GA
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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