Individual
DEBORAH DOBEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4095 COUNTRY CLUB RD, SPARTANBURG, SC 29302-4458
(864) 490-4810
Mailing address
4095 COUNTRY CLUB RD, SPARTANBURG, SC 29302-4458
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
22799
SC
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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