Individual
DR. STEVEN BRUCE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C, D.A.B.C.O
Contact information
Practice address
3508 RICE ST, SAINT PAUL, MN 55126-3170
(651) 483-4321
(651) 483-3440
Mailing address
3508 RICE ST, SHOREVIEW, MN 55126-5002
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
1788
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433527900
—
MN
Enumeration date
10/11/2006
Last updated
10/15/2011
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