Individual
JOYCE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4375 EDDY RIDGE RD, MARION, NY 14505-9333
(315) 524-1084
(315) 524-1119
Mailing address
4375 EDDY RIDGE RD, MARION, NY 14505-9333
(315) 524-1084
(315) 524-1119
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
4746081
NY
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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