DOMINIQUE LATIA JACKSON

KINGS MOUNTAIN, NC
NPI1841054392
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2024-02-06
Last Update Date2024-05-28
Business Address
DOMINIQUE LATIA JACKSON PA-C
812 W KING ST
KINGS MOUNTAIN, NC 28086-2748
Phone number: 704-739-5456
Mailing Address
DOMINIQUE LATIA JACKSON PA-C
200 E 2ND AVE
GASTONIA, NC 28052-4358
Phone number:
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