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1720715592
JACK PHILLIP JACKSON
LONG BEACH, CA
NPI
1720715592
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-08-02
Last Update Date
2022-08-02
Business Address
JACK PHILLIP JACKSON
2025 E 7TH ST
LONG BEACH, CA 90804-4590
Phone number: 562-284-0108
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Mailing Address
JACK PHILLIP JACKSON
2025 E 7TH ST
LONG BEACH, CA 90804-4590
Phone number: 562-284-0108
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