Individual
DR. STEPHEN CHARLES JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
122 N 2ND ST, MILLVILLE, NJ 08332-6512
(856) 825-0452
(856) 327-2307
Mailing address
122 N 2ND ST, MILLVILLE, NJ 08332-6512
(856) 825-0452
(856) 327-2307
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC03904
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1907506
—
NJ
Enumeration date
03/06/2007
Last updated
07/08/2007
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