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Latrese Jackson

NPI 1295316511 · on the registry since 2021 · sole proprietor

Practice

Address
2324 Gwendale Dr W
Lizella, GA 31052
Phone
(478) 250-4601

Registry record

Primary taxonomy
335E00000X
335E00000X
Sex
Female
Record last updated
2021-04-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia