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1457994634
BRANDON JACKSON
LOS ANGELES, CA
NPI
1457994634
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2019-10-21
Last Update Date
2019-10-21
Business Address
Mr. BRANDON JACKSON Recovery Practioner
1873 W 54TH ST
LOS ANGELES, CA 90062-2604
Phone number: 562-794-7892
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Mailing Address
Mr. BRANDON JACKSON Recovery Practioner
1873 W 54TH ST
LOS ANGELES, CA 90062-2604
Phone number: 562-794-7892
Copy
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