Lavar Jackson
NPI #1053914754 in Madison, Mississippi
Provider Information
- NPI Number
- 1053914754
- Entity Type
- Individual
- Name
- Lavar Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Transportation Broker
- Enumeration Date
- Nov 17, 2020
- Last Updated
- Nov 17, 2020
Practice Location
- Address
- 820 ANNANDALE RD
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-7827
- Phone
- (504) 250-1316
Specialties & Taxonomy Codes
| Specialty |
|---|
| Transportation Broker |
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