Marcus Jack's National Provider Identifier (NPI) Details
Marcus Jack,
NPI: 1306591342
Enumeration Date: 2022-02-17
Last updated: 2022-02-17
Sole Proprietor: YES
Status: active
Postal Address: 5640 STONE CT, STONE MOUNTAIN, GA
Phone: 770-912-5225
Primary Practice Address: 12400 S MICHIGAN AVE, CHICAGO, GA
Practice's phone: 770-912-5225