MICHAEL LEE JACKSON

LOUISA, KY
NPI1710721287
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2024-06-20
Last Update Date2024-06-20
Business Address
MICHAEL LEE JACKSON PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
Mailing Address
MICHAEL LEE JACKSON PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938