Individual
EMILY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 LAKEVIEW PKWY, LOCUST GROVE, VA 22508-5232
(540) 220-5261
Mailing address
1200 LAKEVIEW PKWY, LOCUST GROVE, VA 22508-5232
(540) 220-5261
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
VA
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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