Individual
JORDAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 CHEVY LN STE C, BUNKIE, LA 71322-1561
(318) 346-6542
Mailing address
109 CHEVY LN STE C, BUNKIE, LA 71322-1561
(318) 346-6542
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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