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1861943961
JOSHUA DARNELL JACKSON
BATON ROUGE, LA
NPI
1861943961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA 301245)
Enumeration Date
2016-10-24
Last Update Date
2016-10-24
Business Address
-- JOSHUA DARNELL JACKSON LAT, ATC
801 HARDING BLVD
BATON ROUGE, LA 70807-5326
Phone number: 817-312-9960
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Mailing Address
-- JOSHUA DARNELL JACKSON LAT, ATC
1925 N 3RD ST APT 327
BATON ROUGE, LA 70802-5174
Phone number: 817-312-9960
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