Individual
MR. HOWARD LESLIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7801 AIRPORT PULLING RD N, NAPLES, FL 34109-1717
(239) 566-2817
Mailing address
6 KENNEDY PL, TUCKAHOE, NY 10707-1611
(914) 506-0262
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PT 18310
FL
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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