| Doctor Name: | MARK FRANKLIN JACKSON |
| NPI Number: | 1467504365 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T., DPT, MPS, OCS |
| License Number: | 020487 |
| Business Practice Address: | 10 Brentwood Dr Suite A Ithaca, NY - 148501865 |
| Business Phone Number: | 6072744159 |
| Business Fax Number: | 6072744675 |
| Mailing Address: | 39 Evergreen St, CORTLAND |
| State: | NY |
| Postal Code: | 130451109 |
| Phone Number: | 6074237509 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 02/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 020487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |