Individual
PAULA JO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1202 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 835-8771
(575) 835-8345
Mailing address
107 STALLION CIR, SOCORRO, NM 87801-4453
(575) 835-8771
(575) 835-8345
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4257
NM
Other
Enumeration date
01/14/2010
Last updated
01/14/2010
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