Individual
GREGORY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3640 S FULTON AVE UNIT 1411, HAPEVILLE, GA 30354-1770
(424) 284-9663
Mailing address
3640 S FULTON AVE UNIT 1411, HAPEVILLE, GA 30354-1770
(424) 284-9663
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO07189
GA
Other
Enumeration date
05/30/2021
Last updated
05/30/2021
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