| NPI | 1871752105 |
|---|---|
| Doing Business As | JACKSON PROFESSIONAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | BARBARA KAY DOTY Program Sponsor 901-372-7878 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: TN 0000000036) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |