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1740802123
WOMBLE JACKSON
RUSTON, LA
NPI
1740802123
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
Enumeration Date
2020-05-08
Last Update Date
2020-05-08
Business Address
Mr. WOMBLE JACKSON
2003 FRANKLIN AVE
RUSTON, LA 71270-9661
Phone number: 318-331-3977
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Mailing Address
Mr. WOMBLE JACKSON
2003 FRANKLIN AVE
RUSTON, LA 71270-9661
Phone number: 318-331-3977
Copy
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