RALPH JACKSON

SYRACUSE, NY
NPI1720107675
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  265882)
Enumeration Date2007-03-29
Last Update Date2007-07-08
Business Address
-- RALPH JACKSON
813 FAY RD
SYRACUSE, NY 13219-3009
Phone number: 315-488-2831
Mailing Address
-- RALPH JACKSON
PO BOX 494 SYRACUSE
SYRACUSE, NY 13201-0494
Phone number: