Individual
AMANDA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
911 YORK DR, DESOTO, TX 75115-2063
(512) 897-4110
Mailing address
805 EVERGREEN CT, KELLER, TX 76248-3281
(512) 897-4110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15264
TX
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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