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1780887018
PHYLLIS JACKSON
ELMIRA, NY
NPI
1780887018
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 00394441)
Enumeration Date
2007-06-06
Last Update Date
2008-04-03
Business Address
-- PHYLLIS JACKSON
1019 E WATER ST
ELMIRA, NY 14901-3332
Phone number: 607-733-5696
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Mailing Address
-- PHYLLIS JACKSON
1019 E WATER ST
ELMIRA, NY 14901-3332
Phone number:
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