Individual
DR. ELISE LAURA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
51 WATER ST # 205, WATERTOWN, MA 02472-4611
(617) 744-8300
(617) 744-6218
Mailing address
47 MASON ST # 2, SOMERVILLE, MA 02144-1607
(978) 895-6475
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23221
MA
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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