Individual
NICOLE FELIZ JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1301 S US HIGHWAY 377, ARGYLE, TX 76226-7744
(405) 863-7464
Mailing address
16613 J CHESHIER CT, JUSTIN, TX 76247-5778
(405) 863-7464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5523
TX
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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