Individual
MS. ARLISA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7472 CALLAHAN DR, DENHAM SPRINGS, LA 70726-8944
(225) 347-7666
Mailing address
7472 CALLAHAN DR, DENHAM SPRINGS, LA 70726-8944
(225) 347-7666
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
LA
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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