Individual
SYENICKA T JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
323 VILLAGE SQ, BURNS HARBOR, IN 46304-9665
(219) 427-7906
Mailing address
323 VILLAGE SQ, BURNS HARBOR, IN 46304-9665
(219) 427-7906
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
IN
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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