PORSHAI JUANICE JACKSON

CHARLOTTE, NC
NPI1356990022
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
Enumeration Date2019-09-05
Last Update Date2019-09-05
Business Address
PORSHAI JUANICE JACKSON
6341 DERRYFIELD DR
CHARLOTTE, NC 28213-5532
Phone number: 980-230-8248
Mailing Address
PORSHAI JUANICE JACKSON
6341 DERRYFIELD DR
CHARLOTTE, NC 28213-5532
Phone number: 980-230-8248
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