Organization
INTERDISCIPLANARY PAIN MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE JACKSON DC (CEO)
(661) 267-6876
Entity
Organization
Contact information
Practice address
819 AUTO CENTER DRIVE, PALMDALE, CA 93551
(661) 267-6876
(661) 538-9438
Mailing address
819 AUTO CENTER DRIVE, PALMDALE, CA 93551
(661) 267-6876
(661) 538-9438
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
10/23/2006
Last updated
11/07/2007
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