Individual
MRS. CHRISTY WIEST JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 ULYSSES LN, OAK RIDGE, TN 37830-5238
(865) 387-2462
Mailing address
113 ULYSSES LN, OAK RIDGE, TN 37830-5238
(865) 387-2462
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2109
TN
Other
Enumeration date
07/01/2012
Last updated
07/01/2012
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