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Individual

KATHLEEN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3788 JACKSON COMMUNITY RD, VERNON, FL 32462-3440
(850) 527-7197
Mailing address
3788 JACKSON COMMUNITY RD, VERNON, FL 32462-3440
(850) 527-7197

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
FL

Other

Enumeration date
09/30/2019
Last updated
09/30/2019
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