Individual
HOLLY ALEGRO JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10550 MURAT DR, SAINT LOUIS, MO 63136-4524
(314) 358-6051
(314) 869-3373
Mailing address
10550 MURAT DR, SAINT LOUIS, MO 63136-4524
(314) 358-6051
(314) 869-3373
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
MO
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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