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1194985861
BRIAN JAMES JACKSON
SAN DIEGO, CA
NPI
1194985861
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2008-06-16
Last Update Date
2008-06-16
Business Address
-- BRIAN JAMES JACKSON IDC
35000 GUADALCANAL AVE
SAN DIEGO, CA 92140-5599
Phone number: 619-524-4045
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Mailing Address
-- BRIAN JAMES JACKSON IDC
35000 GUADALCANAL AVE
SAN DIEGO, CA 92140-5599
Phone number: 619-524-4045
Copy
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