Individual
STUART JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2806 WOODLAWN ST, DICKINSON, TX 77539-4668
(281) 702-3285
Mailing address
2806 WOODLAWN ST, DICKINSON, TX 77539-4668
(281) 702-3285
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4250
TX
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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