Organization
ACTION JACKSON PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANE LORAN JACKSON DPT (OWNER/PHYSICAL THERAPIST)
(510) 292-5385
Entity
Organization
Contact information
Practice address
2844 SUMMIT ST, SUITE 106, OAKLAND, CA 94609-3637
(510) 763-3005
Mailing address
1005 SOLANO AVE, APT. A, ALBANY, CA 94706-1617
(510) 292-5385
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23897
CA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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