Individual
CAREY JACKSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 MAPLE ST, WHITEVILLE, TN 38075-4708
(731) 212-1163
Mailing address
406 MAPLE ST, WHITEVILLE, TN 38075-4708
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1231901241233737
TN
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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