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1053024315
DAVID DWAYNE JACKSON
BOSSIER CITY, LA
NPI
1053024315
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-01-03
Last Update Date
2023-01-03
Business Address
Mr. DAVID DWAYNE JACKSON
245 PEREGRINE WAY
BOSSIER CITY, LA 71112-2556
Phone number: 318-422-3993
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Mailing Address
Mr. DAVID DWAYNE JACKSON
245 PEREGRINE WAY
BOSSIER CITY, LA 71112-2556
Phone number:
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