Individual
MR. CLINTON O JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12244 BRECKENRIDGE DR, EAGLE RIVER, AK 99577-7656
(907) 694-6161
Mailing address
PO BOX 671288, CHUGIAK, AK 99567-1288
(907) 694-6161
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1090102
AK
Other
Enumeration date
01/10/2011
Last updated
07/01/2019
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