Shanda R. Jackson

NPI #1083767248 in Edmond, Oklahoma

Provider Information

NPI Number
1083767248
Entity Type
Individual
Name
Shanda R. Jackson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
Jan 19, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2312 WOODFORD WAY
City
Edmond
ZIP Code
73034-6444
Phone
(405) 340-1611

Specialties & Taxonomy Codes

Specialty
Pharmacist

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