BRENT CALEB JACKSON

FLATWOODS, KY
NPI1386168847
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: KY  174107)
Enumeration Date2017-07-26
Last Update Date2017-07-26
Business Address
BRENT CALEB JACKSON COTA/L
1100 GRANDVIEW DR
FLATWOODS, KY 41139-1024
Phone number: 606-836-3187
Mailing Address
BRENT CALEB JACKSON COTA/L
1102 HORN ST
ASHLAND, KY 41101-7138
Phone number: 606-694-3187
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