NPI Registry.org

Jackson Personal Care

NPI Registration Record

Provider / OrganizationNPIDate Certified
JACKSON PERSONAL CARE15286963822020-07-24
Entity TypeOrganization
Provider OrganizationJACKSON PERSONAL CARE
Practice Office Address117 STONEWALL DR
INDIANOLA, MS US
Practice Office Telephone6623036959
Mailing Address117 STONEWALL DR
INDIANOLA, MS 387512240 US
Business Telephone6623036959
Authorized OfficialSTACY JACKSON, OWNER
6623036959
HPT Codes
CodeLicense NoState
253Z00000X PRIMARY
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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