Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 E CROSSING BLVD, TERRE HAUTE, IN 47802-5316
(812) 575-4057
Mailing address
6084 WOODCHUCK DR, PENDLETON, IN 46064-8739
(317) 698-0558
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007782A
IN
Other
Enumeration date
02/22/2024
Last updated
02/23/2024
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