JAMIE L BACK

FORT CAMPBELL, KY
NPI1881837755
Former NameJAMIE L SHELTON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy246ZE0500X Specialist/Technologist, Other, EEG
(Licence: TN  8325)
Enumeration Date2009-04-08
Last Update Date2009-04-08
Business Address
Mrs. JAMIE L BACK Registered
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-956-0088
Mailing Address
Mrs. JAMIE L BACK Registered
3701 REDDICK RD
PALMYRA, TN 37142-2127
Phone number: 931-624-9695