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1841651007
BRIAN A JACKSON
MEDFORD, OR
NPI
1841651007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-03-16
Last Update Date
2018-08-23
Business Address
BRIAN A JACKSON CADC I
1025 E MAIN ST
MEDFORD, OR 97504
Phone number: 541-779-1282
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Mailing Address
BRIAN A JACKSON CADC I
1003 E MAIN ST STE 104
MEDFORD, OR 97504-7140
Phone number: 541-779-1282
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