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Individual

MR. JOHN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
(843) 743-7868
(843) 743-7521
Mailing address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
(843) 743-7868
(843) 743-7521

Taxonomy

Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
1113323
KY

Other

Enumeration date
02/19/2009
Last updated
02/19/2009
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