MR. Lyric Jackson

NPI #1972948297 in Rio Rancho, New Mexico

Provider Information

NPI Number: 1972948297
Entity Type: Individual
Name: MR. Lyric Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Apr 30, 2013
Last Updated: Apr 30, 2013

Practice Location

Address: 3513 PLANO VISTA NE
City: Rio Rancho
State: New Mexico
ZIP Code: 87124
Phone: (505) 433-7039

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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