Individual
MR. JACKIE JOE ALSTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2000 GLEN ECHO RD STE 111, NASHVILLE, TN 37215-2857
(615) 657-4805
Mailing address
PO BOX 936535, ATLANTA, GA 31193-6535
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
64
TN
Other
Enumeration date
01/17/2011
Last updated
04/28/2023
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