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1992428890
KATRINA E JACKSON
CHARLOTTESVILLE, VA
NPI
1992428890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: VA 0136000370)
Enumeration Date
2022-09-26
Last Update Date
2022-09-26
Business Address
Miss KATRINA E JACKSON LSA, CSFA
500 MARTHA JEFFERSON DR
CHARLOTTESVILLE, VA 22911-4668
Phone number: 434-654-7200
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Mailing Address
Miss KATRINA E JACKSON LSA, CSFA
115 WOOD DUCK PL APT 303
CHARLOTTESVILLE, VA 22902-8202
Phone number: 757-300-3428
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