MR. Kenneth Lee Jackson
NPI #1154058162 in Lake Charles, Louisiana
Provider Information
- NPI Number
- 1154058162
- Entity Type
- Individual
- Name
- MR. Kenneth Lee Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Non-emergency Medical Transport (VAN)
- Enumeration Date
- Aug 1, 2022
- Last Updated
- Aug 1, 2022
Practice Location
- Address
- 1216 OKLAHOMA ST
- City
- Lake Charles
- State
- Louisiana
- ZIP Code
- 70607-3624
- Phone
- (337) 414-0914
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-emergency Medical Transport (VAN) |
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