Jackson, Willie

Jackson, Willie is an sole proprietor health care provider with primary practice located at 400 N Pima , Mesa AZ 85201-5907. He recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as his primary health care specialty. Jackson, Willie can be contacted via phone (602) 551-0659.

Contact Information

Primary practice address
400 N Pima Mesa AZ 85201-5907
Phone: (602) 551-0659
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X 23683875 Arizona

Profile Details

NPI number 1144061649
LBN Legal business name Jackson, Willie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2024
Last updated Jun 6th, 2024 - about 5 months 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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