Individual
MRS. DEANNA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1926 S COURT ST, VISALIA, CA 93277-5426
(559) 736-3193
Mailing address
1922 S COURT ST, VISALIA, CA 93277-5426
(559) 736-3193
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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