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Individual
MR. HOWARD LESLIE JACKSON
Active
Individual
MR. HOWARD LESLIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PT 18310
FL
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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