Individual
MARY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 DORMAN CENTRE DR, SPARTANBURG, SC 29301-2625
(864) 574-1985
Mailing address
141 DORMAN CENTRE DR, SPARTANBURG, SC 29301-2625
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36729
SC
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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