Individual
JAQUISHA MACKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2780 LAMAR AVE STE 101, MEMPHIS, TN 38114-5017
(901) 672-0716
Mailing address
4597 WATER MILL DR APT 103, MEMPHIS, TN 38116-7492
(901) 538-0036
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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