Individual
BRANDON LAMARR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 BRUNSWICK ST, MOORESVILLE, NC 28115-2246
(704) 977-1412
Mailing address
400 BRUNSWICK ST., 420, MOORESVILLE, NC 28115-2246
(704) 977-1412
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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