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1881097764
SHANTAVIA JACKSON
GAINESVILLE, FL
NPI
1881097764
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-10-06
Last Update Date
2014-10-06
Business Address
-- SHANTAVIA JACKSON
4300 SW 13TH ST
GAINESVILLE, FL 32608-4006
Phone number: 352-374-5600
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Mailing Address
-- SHANTAVIA JACKSON
4300 SW 13TH ST
GAINESVILLE, FL 32608-4006
Phone number: 352-374-5600
Copy
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