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Individual

ROBERT JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2601 W RANDOL MILL RD, ARLINGTON, TX 76012-4289
(817) 694-3037
Mailing address
900 MATISSE DR APT 5010, FORT WORTH, TX 76107-2487

Taxonomy

Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
2119678
TX

Other

Enumeration date
01/29/2019
Last updated
01/29/2019
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