Individual
JACQUES LEO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
530 DONELSON PIKE, NASHVILLE, TN 37214-3729
(615) 889-2511
(615) 316-0559
Mailing address
530 DONELSON PIKE, NASHVILLE, TN 37214-3729
(615) 889-2511
(615) 316-0559
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22095
TN
Other
Enumeration date
09/22/2012
Last updated
09/22/2012
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