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1750924106
RENITA L JACKSON
MONTGOMERY, AL
NPI
1750924106
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-10-17
Last Update Date
2019-10-17
Business Address
RENITA L JACKSON
9532 WYNLAKES PL
MONTGOMERY, AL 36117-8515
Phone number: 334-270-3181
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Mailing Address
RENITA L JACKSON
10100 ELIDA RD
DELPHOS, OH 45833-9056
Phone number: 419-695-8010
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