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Individual
JULIE ANN JACKSON
Active
Individual
JULIE ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
296435
CA
225100000X
Physical Therapist
62913
OR
225100000X
Physical Therapist
Primary
PT296435
CA
Other
Enumeration date
03/22/2019
Last updated
05/28/2020
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