Individual
RAYSHOUN THOMAS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3366 W 130TH ST, CLEVELAND, OH 44111-2614
(216) 703-2397
Mailing address
3366 W 130TH ST, CLEVELAND, OH 44111-2614
(216) 703-2397
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
OH
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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