Search › Georgia › 171M00000X
Tanisha Jackson
NPI 1407311509 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1271 Hogansville Rd Apt 115
Lagrange, GA 30241 - Phone
- (334) 646-1574
Additional practice sites
- 6740 James B Rivers Dr, Stone Mountain, GA
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Sex
- Female
- Record last updated
- 2019-02-04
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