| NPI | 1689443038 |
|---|---|
| Doing Business As | JACKSON CLINC PA DME |
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN C.E.O. 731-422-0330 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2023-12-27 |