Jacob S Jackson, DPT
Physical Therapist in Mount Vernon, IL. Individual provider (NPI-1).
NPI number1982162905
StatusActive
Last updated in NPPESMar 8, 2019
Details
- NPI
- 1982162905
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jacob S Jackson
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 8, 2019
- Last updated
- Mar 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 070024163 | IL | Yes |
Practice location
4110 S Water Tower PlMount Vernon, IL 62864-6544
Phone 618-242-1100 · Fax 618-244-5148
Mailing address
4110 S Water Tower PlMount Vernon, IL 62864-6544
Phone 618-242-1100 · Fax 618-244-5148
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All 29 Physical Therapist providers in Mount Vernon · All 834 providers in Mount Vernon
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