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1952910846
PATRICE QUINETTE JACKSON
BATON ROUGE, LA
NPI
1952910846
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172A00000X Driver
(Licence: LA 005562615)
Enumeration Date
2020-07-27
Last Update Date
2020-07-27
Business Address
Mrs. PATRICE QUINETTE JACKSON
7274 MODESTO AVE
BATON ROUGE, LA 70811-4427
Phone number: 225-288-7917
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Mailing Address
Mrs. PATRICE QUINETTE JACKSON
7274 MODESTO AVE
BATON ROUGE, LA 70811-4427
Phone number: 225-288-7917
Copy
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