Individual
LAQUISHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
726 VIA DEL REY, MESQUITE, TX 75150-3022
(414) 322-4766
Mailing address
726 VIA DEL REY, MESQUITE, TX 75150-3022
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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