JACKSON BLANTON

IRMO, SC
NPI1821774001
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: SC  RBT-23-279488)
Enumeration Date2023-06-23
Last Update Date2023-06-23
Business Address
JACKSON BLANTON
1084 LAKE MURRAY BLVD
IRMO, SC 29063-2821
Phone number: 706-842-5330
Mailing Address
JACKSON BLANTON
PO BOX 2567
AUGUSTA, GA 30903-2567
Phone number: 706-842-5330