Individual
MARVIN LEE JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 HWY 35, OCEAN, NJ 07712-3532
(732) 367-4700
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
(732) 367-4700
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NJ
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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