SAM JACKSON

MESA, AZ
NPI1851750061
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: AZ  LAC-15314)
Enumeration Date2016-02-16
Last Update Date2016-02-16
Business Address
-- SAM JACKSON LAC
4250 E FLORIAN AVE BUILDING #1
MESA, AZ 85206-2797
Phone number: 480-844-1653
Mailing Address
-- SAM JACKSON LAC
924 N COUNTRY CLUB DR BUILDING #1
MESA, AZ 85201-4108
Phone number: 480-969-3800