Individual
MRS. LATONYA C JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 SIMS ST, SIMSBORO, LA 71275-3208
(318) 247-8439
(318) 242-4698
Mailing address
121 SIMS ST, SIMSBORO, LA 71275-3208
(318) 247-8439
(318) 242-4698
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/07/2011
Last updated
03/08/2011
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