Individual
SUMMER LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
325 N STATE OF FRANKLIN RD FL 3, JOHNSON CITY, TN 37604-6171
(423) 439-7201
(423) 439-7219
Mailing address
325 N STATE OF FRANKLIN RD FL 3, JOHNSON CITY, TN 37604-6171
(423) 439-7201
(423) 439-7219
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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