Individual
MRS. COURTNEE SHARDAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 SADDLECREEK DR, MCDONOUGH, GA 30253-8916
(404) 759-4526
Mailing address
403 SADDLECREEK DR, MCDONOUGH, GA 30253-8916
(404) 759-4526
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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