| Doctor Name: | DANIEL SHANE JACKSON |
| NPI Number: | 1952301756 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 2002029465 |
| Business Practice Address: | 8550 Marshall Dr Suite 100 Lenexa, KS - 662141505 |
| Business Phone Number: | 9138941500 |
| Business Fax Number: | 9138941502 |
| Mailing Address: | 8550 Marshall Dr, Suite 100 LENEXA |
| State: | KS |
| Postal Code: | 662141505 |
| Phone Number: | 9138941500 |
| Fax Number: | 9138941502 |
| NPI Enumeration Date: | 07/22/2005 |
| NPI Last Update Date: | 10/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2002029465 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| 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 |