Individual
JACKSON JUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
213 N 13TH ST, CENTERVILLE, IA 52544-1707
(641) 437-7200
(641) 437-7300
Mailing address
213 N 13TH ST, CENTERVILLE, IA 52544-1707
(641) 437-7200
(641) 437-7300
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202217164
VA
183500000X
Pharmacist
Primary
24043
IA
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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