| NPI | 1194855072 |
|---|---|
| Professional Name | SHELIA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 749) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |