Individual
KAYLA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
480 RICHARDS FERRY RD, FREDERICKSBURG, VA 22406-4850
(540) 993-8627
Mailing address
480 RICHARDS FERRY RD, FREDERICKSBURG, VA 22406-4850
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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