Individual
JACKSON MAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSR
Contact information
Practice address
140 PINE ST.,, HAMBURG, NY 14075
(716) 646-4991
(716) 464-4990
Mailing address
140 PINE ST.,, HAMBURG, NY 14075
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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