Individual
DEMARIO JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4909 EL ESTE LN, NORTH LAS VEGAS, NV 89031-5596
(702) 204-1781
Mailing address
4909 EL ESTE LN, NORTH LAS VEGAS, NV 89031-5596
(702) 572-8404
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/19/2014
Last updated
03/05/2014
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