Individual
HEATHER D. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
452 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-5502
(614) 293-4726
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 293-5502
(614) 293-4726
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005535RX
OH
Other
Enumeration date
12/13/2017
Last updated
03/28/2018
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