SHANICKWA JACKSON

HATTIESBURG, MS
NPI1326560319
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: MS  AT0857)
Enumeration Date2017-07-11
Last Update Date2017-07-11
Business Address
SHANICKWA JACKSON
7 LAKEWOOD DR
HATTIESBURG, MS 39402-9425
Phone number: 985-237-2994
Mailing Address
SHANICKWA JACKSON
7 LAKEWOOD DR
HATTIESBURG, MS 39402-9425
Phone number:
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