Individual
MR. EUREKA LAPEARLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
56 W FREDERICK ST, WALKERSVILLE, MD 21793-8254
(301) 898-4300
Mailing address
56 W FREDERICK ST, WALKERSVILLE, MD 21793-8254
(301) 898-4300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
06379
MD
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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