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MR. DESHAUN ANTONIO JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1406 WESTWOOD RD, NATCHEZ, MS 39120-5055
(601) 807-2619
Mailing address
1406 WESTWOOD RD, NATCHEZ, MS 39120-5055
(601) 807-2619

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 4069
MS

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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