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1427178425
JACKIE SUE SHANK
ST AUGUSTINE, FL
NPI
1427178425
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: FL ND812)
Enumeration Date
2007-03-31
Last Update Date
2007-07-08
Business Address
Ms. JACKIE SUE SHANK R.D.
401 PORPOISE POINT DR
ST AUGUSTINE, FL 32084-2959
Phone number: 904-826-4307
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Mailing Address
Ms. JACKIE SUE SHANK R.D.
401 PORPOISE POINT DR
ST AUGUSTINE, FL 32084-2959
Phone number: 904-826-4307
Copy
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