Individual
JOHANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
285 W WIEUCA RD NE, ATLANTA, GA 30342-3321
(404) 998-3724
Mailing address
285 W WIEUCA RD NE, ATLANTA, GA 30342-3321
(404) 998-3724
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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