# JACKSON REHAB SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669528857
- **Authorized official:** MR. JOHN PHILLIP JACKSON OTR (PRESIDENT)
- **Authorized official phone:** (806) 778-9735

## Contact information

- **Practice address:** 5728 67TH ST, LUBBOCK, TX 79424-1406
- **Practice address phone:** (806) 778-9735
- **Mailing address:** 5728 67TH ST, LUBBOCK, TX 79424-1406
- **Mailing address phone:** (806) 778-9735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 102473 | TX | Yes |

## Other

- **Enumeration date:** 01/28/2007
- **Last updated:** 08/22/2020