Individual
PENNY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
801 S MAIN ST, CLINTON, IN 47842-2261
(765) 832-1224
(765) 832-1295
Mailing address
9395 GREENCASTLE RD, TERRE HAUTE, IN 47805-9631
(812) 877-2546
(812) 877-2546
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26020678A
IN
183500000X
Pharmacist
38011
TX
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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