Individual
MRS. MARIAN LOUISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 MAYNARD LN, RUSSELL SPRINGS, KY 42642
(270) 566-5022
Mailing address
750 MAYNARD LN, RUSSELL SPRINGS, KY 42642
(270) 566-5022
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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