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1023720422
KEITH JACKSON
COLUMBUS, OH
NPI
1023720422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
172A00000X Driver
(Licence: OH RR895494)
Enumeration Date
2022-12-16
Last Update Date
2023-08-15
Business Address
KEITH JACKSON
874 STUDER AVE
COLUMBUS, OH 43206-1633
Phone number: 614-704-3100
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Mailing Address
KEITH JACKSON
1426 LOCKBOURNE RD
COLUMBUS, OH 43206-3243
Phone number: 614-704-3100
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