| NPI | 1548334758 |
|---|---|
| Other Name | JACKSON CREATIVE |
| Entity Type | Organization |
| Authorized Contact | GLENN BUTLER Billing Mgr 706-227-7250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |