Individual
STEVEN DARRELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
1914 WEBSTER ST, MUSCLE SHOALS, AL 35661-2000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-037117
AL
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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