CHAVIS JACKSON

SPOKANE, WA
NPI1841723459
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-04-10
Last Update Date2017-04-10
Business Address
-- CHAVIS JACKSON D.O
101 W 8TH AVE
SPOKANE, WA 99204-2307
Phone number: 801-707-3121
Mailing Address
-- CHAVIS JACKSON D.O
914 E SAN REMO AVE
GILBERT, AZ 85234-3558
Phone number: 801-707-3121