Lasalle Jackson is a Driver based in Port Gibson, MS. Lasalle Jackson practices in Port Gibson, MS. The NPI Number for Lasalle Jackson is 1508331711 and holds a License No. (Mississippi).
The current practice location address for Lasalle Jackson is 606 Walnut St, Port Gibson, MS and can be reached out via phone at 601-529-0527.
Location: 606 Walnut St, Port Gibson, MS, 39150-2140
Provider Profile Details
NPI Number
1508331711
Provider Name
Lasalle Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
606 Walnut St, Port Gibson, MS, 39150-2140
Phone Number
601-529-0527
Fax Number
Provider Enumeration Date
10/04/2018
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
606 Walnut St
City
State
Zip
39150-2140
Phone Number
601-529-0527
Fax Number
Provider Business Mailing Address Details
Address
606 Walnut St
City
State
Zip
39150-2140
Phone Number
601-529-0527
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
(Mississippi)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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