Doctor Name: | DR. BENJAMIN CALEB JACKSON |
NPI Number: | 1972830313 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C |
License Number: | 1591 |
Business Practice Address: | 522 College Dr Torrington, WY - 822401517 |
Business Phone Number: | 3075322225 |
Business Fax Number: | 3075342202 |
Mailing Address: | 522 College Dr, TORRINGTON |
State: | WY |
Postal Code: | 822401517 |
Phone Number: | 3075322225 |
Fax Number: | 3075342202 |
NPI Enumeration Date: | 11/05/2009 |
NPI Last Update Date: | 04/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 1591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |