Individual
RABUN DAKOTA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2236 HOYT DR, BATON ROUGE, LA 70816-3384
(225) 620-6773
Mailing address
2236 HOYT DR, BATON ROUGE, LA 70816-3384
(225) 620-6773
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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