Individual
DR. AMANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7301 THEODORE DAWES RD, THEODORE, AL 36582-4029
(251) 653-9831
Mailing address
7301 THEODORE DAWES RD, THEODORE, AL 36582-4029
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20344
AL
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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