Individual
TERRY LAMONT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BARBER
Contact information
Practice address
1101 E YANDELL DR, EL PASO, TX 79902-5524
(915) 345-7917
Mailing address
1101 E YANDELL DR, EL PASO, TX 79902-5524
(915) 345-7917
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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