Mr. Robert Wallace Jackson Jr.
Mr. Robert Wallace Jackson Jr. is an In Home Supportive Care Agency in Marietta, Georgia. Practices as a sole proprietor. Licensed in Georgia.
- Licensed in
- GA
- In the registry since
- 2021
Practice location Address checks out
1355 Terrell Mill Rd SE Bldg 1462-125Marietta, GA 30067-5559
Phone: (470) 632-7400
Fax: (470) 524-0500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| In Home Supportive Care Agency (primary) | Taxonomy 253Z00000X · Licence PHCP010932 (GA) |
|---|
Record details
| NPI number | 1932791993 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 10, 2021 |
| Last updated in NPPES | February 10, 2021 |
| Certification date | February 10, 2021 |
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