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Individual

MR. JUSTIN ANDREW JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
2409 HOMER CLAYTON DRIVE, GUNTERSVILLE, AL 35976-2207
(256) 582-4240
(256) 582-4161
Mailing address
2409 HOMER CLAYTON DRIVE, GUNTERSVILLE, AL 35976-2207
(256) 582-4240
(256) 582-4161

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/27/2020
Last updated
02/27/2020
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