Individual
JAMIE LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1010 W NORTH ST, GIRARD, IL 62640-1061
(217) 622-1817
Mailing address
312 E MAIN ST, CARLINVILLE, IL 62626-1814
(314) 761-8822
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006056
IL
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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