Vaughn D Jackson, Pllc

NPI 1710308952 - Clinic/Center - 261QM2500X

NPI Details
NPI 1710308952
Enumeration Date 12/13/2013
Last Updated 12/13/2013
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Phone (719) 274-4500
Fax (719) 274-4504
Practice Location
412 MAIN
LA JARA CO, 81140, US
Phone (719) 274-4500
Fax (719) 274-4504
Business Location
P.O. BOX 272
416 MAIN
LA JARA CO, 81140, US
Phone (719) 274-4500
Fax (719) 274-4504
Taxonomy Code 261QM2500X
License State Colorado
License Number 31351
Remove 1710308952 NPI Number

According to our database, Vaughn D Jackson, Pllc NPI is 1710308952, taxonomy code is 261QM2500X and license number is 31351, license state is located at Colorado. Vaughn D Jackson, Pllc physically located at 412 Main, La Jara CO, 81140. NPI Number 1033115704 has the healthcare provider type.

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1710308952 NPI number is provided on an as is basis without warranty of any kind. 1710308952 is maintained by the National Plan & Provider Enumeration System. The contents of Vaughn D Jackson, Pllc are for informational purposes only.