| NPI | 1659149839 |
|---|---|
| Doing Business As | JACKSON LAB SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | GEMONTASIA JACKSON Director 414-939-5802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |