Individual
SARAH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 MILES ST, ATHENS, GA 30601-1820
(706) 369-6310
Mailing address
4704 MELBOURNE TRL, FLOWERY BRANCH, GA 30542-6419
(678) 617-0745
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
240679
GA
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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