Individual
JOSHUA RASHAD JACKSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6340 N 84TH ST APT 5, MILWAUKEE, WI 53225-1972
(414) 233-5907
Mailing address
N67W13215 DAYLILY DR, MENOMONEE FALLS, WI 53051-0504
(414) 233-5907
(262) 345-5550
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
832046773
—
WI
Enumeration date
08/22/2019
Last updated
11/27/2023
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