Individual
MR. JACKSON CRISTOFER GARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
3479 BUCKHORN DR STE 106, LEXINGTON, KY 40515-1114
(859) 253-1686
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
02/22/2022
Last updated
02/22/2022
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