Individual
LARRY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 5TH AVE N, ST PETERSBURG, FL 33705-2008
(727) 896-8686
(727) 898-9596
Mailing address
1501 5TH AVE N, ST PETERSBURG, FL 33705-2008
(727) 896-8686
(727) 898-9596
Taxonomy
Speciality
Code
Description
License number
State
1744R1102X
Research Study Specialist
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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