STANFORD JACKSON

LAS VEGAS, NV
NPI1750688933
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2011-02-23
Last Update Date2011-02-23
Business Address
STANFORD JACKSON
8321 W SAHARA AVE APT 2007
LAS VEGAS, NV 89117-1883
Phone number: 702-562-3569
Mailing Address
STANFORD JACKSON
8321 W SAHARA AVE APT 2007
LAS VEGAS, NV 89117-1883
Phone number: 702-562-3569
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