Individual
MS. JUDY MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5941 WILERSON RD., REX, GA 30273-1506
(678) 284-1355
(678) 284-1355
Mailing address
5941 WILERSON RD., W, REX, GA 30273-1506
(678) 284-1355
(678) 284-1355
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
031-01-129-1
GA
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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