JACKIE SUE SHANK

ST AUGUSTINE, FL
NPI1427178425
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: FL  ND812)
Enumeration Date2007-03-31
Last Update Date2007-07-08
Business Address
Ms. JACKIE SUE SHANK R.D.
401 PORPOISE POINT DR
ST AUGUSTINE, FL 32084-2959
Phone number: 904-826-4307
Mailing Address
Ms. JACKIE SUE SHANK R.D.
401 PORPOISE POINT DR
ST AUGUSTINE, FL 32084-2959
Phone number: 904-826-4307