Michael Jackson
NPI #1801365382 in Garden City, Idaho
Provider Information
- NPI Number
- 1801365382
- Entity Type
- Individual
- Name
- Michael Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Nov 14, 2018
- Last Updated
- Nov 14, 2018
Practice Location
- Address
- 5537B N GLENWOOD ST STE B
- City
- Garden City
- State
- Idaho
- ZIP Code
- 83714-1336
- Phone
- (208) 789-9075
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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