ATAVIA JACKSON, ST
Contractor
Active
Individual
NPI: 1528550209
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Contractor | 171W00000X | Yes | - |
Frequently Asked Questions
NPI 1528550209 is the National Provider Identifier for ATAVIA JACKSON, ST, a Contractor provider located in Morven, GA. This NPI was enumerated on May 30, 2018.
ATAVIA JACKSON, ST practices at 5229 JACKSON RD, Morven, GA 31638.
Quick Facts
- NPI
- 1528550209
- Type
- Individual
- Enumerated
- May 30, 2018
- Last Updated
- May 30, 2018
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