Individual
MR. ANTHONY JACKSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, QMHS
Contact information
Practice address
700 LIBERTY LN, WEST CARROLLTON, OH 45449-2135
(614) 844-3800
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/23/2018
Last updated
09/13/2023
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