ATAVIA JACKSON, ST

Contractor

Active Individual
NPI: 1528550209

Practice Address

5229 JACKSON RD
Morven, GA 31638

Phone: (229) 561-5507

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

Nearby Providers