MICHAEL LATRELLE JACKSON

ROCK HILL, SC
NPI1942050059
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy374U00000X Home Health Aide
(Licence: SC  IHCP-2092)
Enumeration Date2024-03-25
Last Update Date2024-05-20
Business Address
MICHAEL LATRELLE JACKSON
1156 BANNOCKBURN AVE
ROCK HILL, SC 29732-1095
Phone number: 803-718-5292
Mailing Address
MICHAEL LATRELLE JACKSON
1156 BANNOCKBURN AVE
ROCK HILL, SC 29732-1095
Phone number: 803-718-5292
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