DAVID DWAYNE JACKSON

BOSSIER CITY, LA
NPI1053024315
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2023-01-03
Last Update Date2023-01-03
Business Address
Mr. DAVID DWAYNE JACKSON
245 PEREGRINE WAY
BOSSIER CITY, LA 71112-2556
Phone number: 318-422-3993
Mailing Address
Mr. DAVID DWAYNE JACKSON
245 PEREGRINE WAY
BOSSIER CITY, LA 71112-2556
Phone number: