Individual
JOEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC,CPO
Contact information
Practice address
214 POENISCH DR, CORPUS CHRISTI, TX 78412-2708
(307) 258-6541
Mailing address
214 POENISCH DR, CORPUS CHRISTI, TX 78412-2708
(307) 258-6541
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
2206
TX
224P00000X
Prosthetist
Primary
2206
TX
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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