DENISE JACKSON

JOHNS CREEK, GA
NPI1306330303
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224P00000X Prosthetist
(Licence: GA  CO124581)
Additional Taxonomies224P00000X Prosthetist
(Licence: IN  BC29700281)
Enumeration Date2018-06-21
Last Update Date2018-06-27
Business Address
DENISE JACKSON
11720 MEDLOCK BRIDGE RD STE 155
JOHNS CREEK, GA 30097
Phone number: 574-320-3549
Mailing Address
DENISE JACKSON
11720 MEDLOCK BRIDGE RD STE 155
JOHNS CREEK, GA 30097-1513
Phone number: 574-320-3549