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Latoria Jackson
NPI 1922500289 · on the registry since 2018 · sole proprietor
Practice
- Address
- 4150 Alexis Ct
Loganville, GA 30052 - Phone
- (678) 671-0078
- Fax
- (888) 948-2083
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Also registered as
- 171M00000X
251B00000X
251C00000X
251S00000X
261QA0600X
261QD1600X
3104A0625X
320600000X
320900000X
372600000X
373H00000X - Sex
- Female
- Record last updated
- 2018-03-02
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