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1225643174
JAY JACKSON SWANSON
ROCKFORD, IL
NPI
1225643174
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178017319)
Enumeration Date
2020-09-08
Last Update Date
2023-05-30
Business Address
Mr. JAY JACKSON SWANSON
6072 BRYNWOOD DR STE 205
ROCKFORD, IL 61114-5829
Phone number: 815-846-0684
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Mailing Address
Mr. JAY JACKSON SWANSON
4432 GLENMORE RD
ROCKTON, IL 61072-3234
Phone number: 815-721-0189
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