Individual
LATOYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5510 WARES FERRY RD STE F, MONTGOMERY, AL 36117-2129
(334) 676-2422
Mailing address
5510 WARES FERRY RD STE F, MONTGOMERY, AL 36117-2129
(334) 676-2422
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
202600003153
AL
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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