MICHAEL ANTHONY JACKSON

LOUISA, KY
NPI1477201994
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Additional Taxonomies175T00000X Peer Specialist
Enumeration Date2022-03-14
Last Update Date2023-12-28
Business Address
MICHAEL ANTHONY JACKSON PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
Mailing Address
MICHAEL ANTHONY JACKSON PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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