Individual
AMY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6928
(570) 235-1667
(570) 235-1667
Mailing address
1155 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6928
(570) 235-1667
(570) 235-1667
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
230750
PA
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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