Individual
TERIK JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4103 S YALE AVE STE B, TULSA, OK 74135-6002
(918) 382-7300
Mailing address
4103 S YALE AVE STE B, TULSA, OK 74135-6002
(918) 382-7300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93595815A
—
CA
Enumeration date
10/17/2022
Last updated
10/17/2022
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