Individual
JILL JACOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8711
Mailing address
2518 BAYBERRY DR, LODI, CA 95242-4607
(209) 333-8541
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
6673
CA
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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