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Organization
LYNN JACKSON, PT, PC
Active
Organization
LYNN JACKSON, PT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN JACKSON PT ,PC (OWNER)
(512) 899-8508
Entity
Organization
Contact information
Practice address
6012 W WILLIAM CANNON DR, BLDG C-101, AUSTIN, TX 78749-1980
(512) 899-8508
(512) 899-9387
Mailing address
PO BOX 91419, AUSTIN, TX 78709-1419
(512) 899-8508
(512) 899-9387
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1113850
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689779522
NPI-INDIVIDUAL
TX
Enumeration date
01/15/2008
Last updated
01/15/2008
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