KENNETH MARLON JACKSON

BATON ROUGE, LA
NPI1902612740
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172A00000X Driver
(Licence: LA  002515859)
Enumeration Date2024-12-06
Last Update Date2024-12-06
Business Address
KENNETH MARLON JACKSON
8630 ANTIOCH RD
BATON ROUGE, LA 70817-6413
Phone number: 504-667-8133
Mailing Address
KENNETH MARLON JACKSON
8630 ANTIOCH RD
BATON ROUGE, LA 70817-6413
Phone number: 504-667-8133