Individual
AMANDA MARCONI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1800 N MISSOURI ST, SUITE 2, WEST MEMPHIS, AR 72301-1791
(870) 735-8987
Mailing address
611 CHARLESWOOD DR, MARION, AR 72364-1839
(870) 702-1004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD09886
AR
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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