Alexius Wanequal Jackson

NPI #1578042172 in Jefferson, Texas

Provider Information

NPI Number
1578042172
Entity Type
Individual
Name
Alexius Wanequal Jackson
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Licensed Vocational Nurse
Enumeration Date
Aug 14, 2018
Last Updated
Aug 14, 2018

Practice Location

Address
120 N WALNUT ST
State
Texas
ZIP Code
75657-1934
Phone
(903) 665-6131

Specialties & Taxonomy Codes

Specialty
Licensed Vocational Nurse

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