DOMINIQUE LATIA JACKSON

SHELBY, NC
NPI1841054392
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  0010-14318)
Enumeration Date2024-02-06
Last Update Date2024-08-27
Business Address
DOMINIQUE LATIA JACKSON PA-C
1760 E DIXON BLVD
SHELBY, NC 28152-6948
Phone number: 704-480-9344
Mailing Address
DOMINIQUE LATIA JACKSON PA-C
200 E 2ND AVE
GASTONIA, NC 28052-4358
Phone number:
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