Individual
JACKSON CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
125 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
(434) 200-7860
Mailing address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-5032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305210477
VA
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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