Individual
DRAKE EDWARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9400 S. BERMUDA RD. APT 379, LAS VEGAS, NV 89123-4420
(323) 681-5278
Mailing address
9400 BERMUDA RD APT 379, LAS VEGAS, NV 89123-4420
(323) 681-5278
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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