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1467711986
BRUCE JACKSON
LOS ANGELES, CA
NPI
1467711986
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-05-04
Last Update Date
2012-05-04
Business Address
-- BRUCE JACKSON
5715 S BROADWAY
LOS ANGELES, CA 90037-4131
Phone number: 323-948-0444
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Mailing Address
-- BRUCE JACKSON
5715 S BROADWAY
LOS ANGELES, CA 90037-4131
Phone number: 323-948-0444
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