TRAVIS JACKSON

TALLULAH, LA
NPI1720573678
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2018-06-23
Last Update Date2018-06-23
Business Address
TRAVIS JACKSON
124 KIMBROUGH BLVD BLDG Q124
TALLULAH, LA 71282-4307
Phone number: 318-574-4400
Mailing Address
TRAVIS JACKSON
124 KIMBROUGH BLVD BLDG Q124
TALLULAH, LA 71282-4307
Phone number: 318-574-4400
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