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Shante Jackson
NPI 1790428852 · on the registry since 2022 · sole proprietor
Practice
- Address
- 1597 Holly Brook Rd
Snellville, GA 30078 - Phone
- (203) 725-2004
Registry record
- Primary taxonomy
- 376K00000X
376K00000X
- Sex
- Female
- Record last updated
- 2022-04-17
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