Jackson, Latrese
Jackson, Latrese is an sole proprietor health care provider with primary practice located at 2324 Gwendale Dr W , Lizella GA 31052-3550. She recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as her primary health care specialty. Jackson, Latrese can be contacted via phone (478) 250-4601.Contact Information
Primary practice address
2324 Gwendale Dr W
Lizella GA 31052-3550
Phone: (478) 250-4601
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Prosthetic/Orthotic Supplier | 335E00000X |
Profile Details
NPI number | 1295316511 |
---|---|
LBN Legal business name | Jackson, Latrese |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 19th, 2021 |
Last updated | Apr 19th, 2021 - about 4 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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