BRUCE L JACKSON

APPLE VALLEY, CA
NPI1124072087
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: CA  PA14185)
Enumeration Date2006-05-22
Last Update Date2007-07-08
Business Address
Mr. BRUCE L JACKSON P.A.
15863 KASOTA RD
APPLE VALLEY, CA 92307-4507
Phone number: 760-948-1454
Mailing Address
Mr. BRUCE L JACKSON P.A.
11919 HESPERIA RD
HESPERIA, CA 92345-1855
Phone number: 760-948-1454