Individual
DR. COURTNEY MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9150 MCMAHON BLVD NW, ALBUQUERQUE, NM 87114-5201
(816) 262-7124
Mailing address
16002 COUNTY ROAD 311, SAVANNAH, MO 64485-2234
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0015107
CO
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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