Individual
ALISA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
11351 E WASHINGTON ST, INDIANAPOLIS, IN 46229-3101
(317) 894-6710
Mailing address
4555 EASTBOURNE DR, INDIANAPOLIS, IN 46226-3368
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26025355A
IN
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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