Individual
MS. CARRIE MICHELE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D, L..D
Contact information
Practice address
206 RESCIA AVE, RAINBOW CITY, AL 35906-5933
(256) 413-7154
(256) 413-7813
Mailing address
3102 DAYBROOKE CIR, OWENS CROSS ROADS, AL 35763-9089
(256) 679-8484
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1188
AL
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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