Individual
JACKSON BYESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1409 W GEORGIA RD, STE C, SIMPSONVILLE, SC 29680-6419
(630) 296-2223
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8062
SC
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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