Individual
JULIAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 S LAFAYETTE ST, DEARBORN, MI 48124-1314
(312) 343-0847
Mailing address
413 HOME AVE APT 4C, OAK PARK, IL 60302-3720
(312) 343-0847
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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