Individual
JESSICA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
120 MAIN ST APT 217, SACO, ME 04072-3528
(817) 422-6403
Mailing address
120 MAIN ST APT 217, SACO, ME 04072-3528
(817) 422-6403
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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