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1659991305
LIYAH JACKSON
DAVENPORT, IA
NPI
1659991305
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-04-23
Last Update Date
2020-04-23
Business Address
Ms. LIYAH JACKSON
1607 W 12TH ST
DAVENPORT, IA 52804-4086
Phone number: 331-662-8951
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Mailing Address
Ms. LIYAH JACKSON
420 W RIVER DR
DAVENPORT, IA 52801-1150
Phone number:
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