Kevin Anthony Jackson
Kevin Anthony Jackson is a Driver in Lake Havasu City, Arizona. Practices as a sole proprietor. Licensed in Arizona.
- Licensed in
- AZ
- In the registry since
- 2024
Practice location Address checks out
2470 Constellation Dr Unit 103Lake Havasu City, AZ 86403-4944
Phone: (310) 484-8432
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence D08566611 (AZ) |
|---|
Record details
| NPI number | 1427829548 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 9, 2024 |
| Last updated in NPPES | January 9, 2024 |
| Certification date | January 9, 2024 |