Individual
DR. JACKSON LANE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
8322 PINEVILLE MATTHEWS RD, CHARLOTTE, NC 28226-4707
(704) 496-5228
Mailing address
17200 BRIDGETON LN, HUNTERSVILLE, NC 28078-4808
(423) 415-2472
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
45317
TN
Other
Enumeration date
07/29/2021
Last updated
10/12/2024
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