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1881047710
LILLIE JACKSON
BIRMINGHAM, AL
NPI
1881047710
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AL PA.1146)
Enumeration Date
2016-07-15
Last Update Date
2018-12-31
Business Address
LILLIE JACKSON PA
4704 CAHABA RIVER RD # 101D
BIRMINGHAM, AL 35243-2344
Phone number: 205-739-2266
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Mailing Address
LILLIE JACKSON PA
PO BOX 2391
BIRMINGHAM, AL 35201-2391
Phone number: 205-868-2000
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