Individual
JODY M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 WENTWORTH AVE E, SUITE 240, WEST ST PAUL, MN 55118-3431
(612) 770-7565
Mailing address
33 WENTWORTH AVE E, SUITE 240, WEST ST PAUL, MN 55118-3431
(612) 770-7565
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
153830-6
MN
Other
Enumeration date
05/29/2015
Last updated
12/26/2015
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