Individual
MR. WILLIAM JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 LINCOLN BLVD, BEDFORD, OH 44146-3730
(216) 214-8907
Mailing address
P.O.BOX 37247, BEDFORD, OH 44146-9998
(216) 214-8907
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
OH
172A00000X
Driver
Primary
—
OH
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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