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Individual

MATTHEW AARON JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
711 COOLIDGE ST, LONDON, KY 40741-1374
(606) 545-8243
Mailing address
711 COOLIDGE ST, LONDON, KY 40741-1374
(606) 545-8243

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
KY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
KY

Other

Enumeration date
09/26/2025
Last updated
09/26/2025
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