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1669861985
ANNIE JACK
INDEPENDENCE, MO
NPI
1669861985
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MO 2012011146)
Enumeration Date
2015-01-12
Last Update Date
2015-01-12
Business Address
-- ANNIE JACK
3980 E JACKSON DR
INDEPENDENCE, MO 64057-2205
Phone number: 816-795-1433
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Mailing Address
-- ANNIE JACK
703 NW PAR DR
GRAIN VALLEY, MO 64029-7347
Phone number:
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