Organization
INTEGRATED SPECIALTY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MANDI JACKSON FNP-C (OWNER)
(314) 610-2277
Entity
Organization
Contact information
Practice address
26133 GILMORE WAY, DAPHNE, AL 36526-0079
(314) 610-2277
Mailing address
26133 GILMORE WAY, DAPHNE, AL 36526-0079
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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