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1467671982
RICHARD CHAD JACKSON
CORBIN, KY
NPI
1467671982
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: KY 311)
Enumeration Date
2007-04-24
Last Update Date
2007-07-08
Business Address
-- RICHARD CHAD JACKSON
1 TRILLIUM WAY
CORBIN, KY 40701-8426
Phone number: 606-523-8521
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Mailing Address
-- RICHARD CHAD JACKSON
920 BARGO ST
LONDON, KY 40741-2710
Phone number: 606-878-7658
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