Individual
JACKSON SANGUILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3827 N LAFAYETTE ST, DENVER, CO 80205-5089
(303) 500-1518
Mailing address
6 CARRIAGE WALK LN APT 342, SCARBOROUGH, ME 04074-8296
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
Q212354
CO
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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