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Rose Jackson
NPI 1316122088 · on the registry since 2007 · sole proprietor
Practice
- Address
- 3450 Indiana Ave
Saint Louis, MO 63118 - Phone
- (314) 249-9765
- Fax
- (314) 771-5063
Registry record
- Primary taxonomy
- 251E00000X
251E00000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-01-09
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 Missouri