Individual
JACKIE LEANNE JUSTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 MCGHEE ST, MARYVILLE, TN 37801-6811
(865) 983-4582
(865) 983-4574
Mailing address
301 MCGHEE ST, MARYVILLE, TN 37801-6811
(865) 983-4582
(865) 983-4574
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
93903
TN
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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