Individual
WESLEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2102 SANDBROOK DR, JONESBORO, AR 72404-0686
(870) 351-0869
Mailing address
2102 SANDBROOK DR, JONESBORO, AR 72404-0686
(870) 351-0869
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A1144
AR
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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