CHARLES LEE JACKSON

LAS VEGAS, NV
NPI1386937183
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: NV  2012)
Enumeration Date2011-05-26
Last Update Date2011-05-26
Business Address
-- CHARLES LEE JACKSON PTA
2250 E FLAMINGO RD
LAS VEGAS, NV 89119-5170
Phone number: 702-784-4303
Mailing Address
-- CHARLES LEE JACKSON PTA
2905 PORTADA AVE
HENDERSON, NV 89074-2845
Phone number: 702-635-6033
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