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1225639297
CODY JAMES JACKSON
PORTAGE, IN
NPI
1225639297
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: IN 26027744A)
Enumeration Date
2020-11-05
Last Update Date
2020-11-05
Business Address
Dr. CODY JAMES JACKSON PharmD
6087 US HIGHWAY 6
PORTAGE, IN 46368-5046
Phone number: 219-759-5811
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Mailing Address
Dr. CODY JAMES JACKSON PharmD
314 TIMI DR
VALPARAISO, IN 46385-8504
Phone number: 219-742-4663
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