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1720107675
RALPH JACKSON
SYRACUSE, NY
NPI
1720107675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 265882)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
-- RALPH JACKSON
813 FAY RD
SYRACUSE, NY 13219-3009
Phone number: 315-488-2831
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Mailing Address
-- RALPH JACKSON
PO BOX 494 SYRACUSE
SYRACUSE, NY 13201-0494
Phone number:
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