NPI 1306330303

Denise Jackson

Practitioner Prosthetist Johns Creek, GA

Practice location

Address: 11720 Medlock Bridge Rd STE 155, Johns Creek, GA 30097
Phone: (574) 320-3549
Mailing address: 11720 Medlock Bridge Rd STE 155, Johns Creek, GA 30097-1513

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence CO124581 (GA)

Other Prosthetist providers in Georgia →

Prosthetist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence BC29700281 (IN)

Registry record

NPI: 1306330303
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2018
Record last updated: 27 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.