Individual
MRS. ALLISON NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
190 WALLER DR, CRITTENDEN, KY 41030-8723
(859) 803-3993
Mailing address
190 WALLER DR, CRITTENDEN, KY 41030-8723
(859) 803-3993
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT. 004757
OH
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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