Individual
AMY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 WINDFLOWER LN STE 100, SOLON, IA 52333-4708
(319) 624-2239
(319) 624-3186
Mailing address
620 15TH AVE SW, MOUNT VERNON, IA 52314-4701
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19165
IA
Other
Enumeration date
03/28/2006
Last updated
12/31/2020
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