Individual
MR. JACK EDWARD JONES II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 LAKE SHORE DR, RANCHO MIRAGE, CA 92270-4054
(760) 469-3208
Mailing address
90 LAKESHORE DR., RANCHO MIRAGE, CA 92270
(760) 469-3208
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
482707
CA
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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