Jackson, David

Jackson, David is an individual health care provider with primary practice located at 2310 E 8Th St , Cheyenne WY 82001-5256. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Jackson, David can be contacted via phone (307) 632-6433.

Contact Information

Primary practice address
2310 E 8Th St Cheyenne WY 82001-5256
Phone: (307) 632-6433
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1376821645
LBN Legal business name Jackson, David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2011
Last updated Aug 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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