Individual
FAITH ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
96 15TH ST NW STE 104, NORTON, VA 24273-1600
(276) 679-0321
Mailing address
96 15TH ST NW STE 104, NORTON, VA 24273-1600
(276) 679-0321
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0116039099
VA
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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