Individual
MACKENZIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-3627
Mailing address
210 RESERVE BLVD APT 405, CHARLOTTESVILLE, VA 22901-1597
(803) 246-1096
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202223750
VA
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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