SearchGeorgia376K00000X

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