KELLIE JEANNIE JACK

EUREKA, CA
NPI1437305265
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2008-08-12
Last Update Date2014-04-04
Business Address
Ms. KELLIE JEANNIE JACK
720 WOOD ST
EUREKA, CA 95501-4413
Phone number: 707-268-2990
Mailing Address
Ms. KELLIE JEANNIE JACK
2266 REDWOOD ST APT G
EUREKA, CA 95503-6268
Phone number: 707-834-6923
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