Doctor Name: | MATTHEW JACKSON |
NPI Number: | 1992027775 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT, MOT,ATC |
License Number: | 07464 |
Business Practice Address: | 187 Ninth St Jena, LA - 713422780 |
Business Phone Number: | 3189929200 |
Business Fax Number: | 3189929280 |
Mailing Address: | 187 Ninth St, JENA |
State: | LA |
Postal Code: | 71342 |
Phone Number: | 3189929200 |
Fax Number: | 3189929280 |
NPI Enumeration Date: | 02/22/2010 |
NPI Last Update Date: | 02/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 07464 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
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 |