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Andria Jackson
Prosthetics Case Management in Upper Marlboro, Maryland
NPI 1073138285

Andria Jackson is a Prosthetics Case Management based in Upper Marlboro, MD and is specialized in Prosthetics Case Management. Andria Jackson practices in Upper Marlboro, MD. The NPI Number for Andria Jackson is 1073138285 and holds a License No. 407120 (Maryland).

The current practice location address for Andria Jackson is 9560 Marlboro Pike Ste 105, Upper Marlboro, MD and can be reached out via phone at 301-535-7542.

Location: 9560 Marlboro Pike Ste 105, Upper Marlboro, MD, 20772-3770
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Provider Profile Details
NPI Number
1073138285
Provider Name
Andria Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
9560 Marlboro Pike Ste 105, Upper Marlboro, MD, 20772-3770
Phone Number
301-535-7542
Fax Number
Provider Enumeration Date
06/12/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
407120 01 MD COSMETOLOGY LICENCE
institution
Provider Business Practice Location Address Details
Address
9560 Marlboro Pike Ste 105
City
State
Zip
20772-3770
Phone Number
301-535-7542
Fax Number
person
Provider Business Mailing Address Details
Address
9560 Marlboro Pike Ste 105
City
State
Zip
20772-3770
Phone Number
301-535-7542
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
License No.
407120 (Maryland)
Definition
Definition to come...
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