Individual
SHARIKA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3123 REEVES ST SE, SMYRNA, GA 30080-4151
(404) 754-8827
Mailing address
3123 REEVES ST SE, SMYRNA, GA 30080-4151
(404) 754-8827
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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