Individual
MATTHEW JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
161 FALMOUTH RD, MASHPEE, MA 02649-2662
(508) 477-2490
Mailing address
50 NEW PLAINVILLE RD, APT K61, NEW BEDFORD, MA 02745-4943
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11297
MA
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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