Lauren L Jackson, DPT
Physical Therapist in Port Jefferson, NY. Individual provider (NPI-1).
NPI number1851664569
StatusActive
Last updated in NPPESFeb 13, 2012
Details
- NPI
- 1851664569
- Entity type
- Individual (NPI-1)
- Name
- Lauren L Jackson
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 13, 2012
- Last updated
- Feb 13, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 031984 | NY | Yes |
Practice location
200 Belle Terre RdPort Jefferson, NY 11777-1928
Phone 631-474-6111
Mailing address
16 Seacliff LnMiller Place, NY 11764-1526
Phone 718-440-5891
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All 42 Physical Therapist providers in Port Jefferson · All 1,173 providers in Port Jefferson
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