Individual
ISAAC T. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
3916 WOODREED DR, BRANDYWINE, MD 20613-6006
(301) 526-8416
Mailing address
3916 WOODREED DR, BRANDYWINE, MD 20613-6006
(301) 526-8416
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
1241364241
MD
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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