Individual
AARON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 N BROAD ST, PHILADELPHIA, PA 19121-5139
(917) 283-8967
Mailing address
11346 194TH ST, SAINT ALBANS, NY 11412-2424
(917) 283-8967
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007326
PA
Other
Enumeration date
12/05/2018
Last updated
11/15/2019
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