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1023870227
BRYAN JACKO
LANCASTER, CA
NPI
1023870227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-01-24
Last Update Date
2024-01-24
Business Address
BRYAN JACKO
44421 10TH ST W
LANCASTER, CA 93534-3335
Phone number: 818-996-1051
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Mailing Address
BRYAN JACKO
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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