SearchMissouri343900000X

Holly Jackson

NPI 1689156721 · on the registry since 2018 · sole proprietor

Practice

Address
10550 Murat Dr
Saint Louis, MO 63136
Phone
(314) 358-6051
Fax
(314) 869-3373

Registry record

Primary taxonomy
343900000X
343900000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-09-05

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