Individual
DR. CHARLEY DAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1618 HIGHWAY 51 S, SUITE F, COVINGTON, TN 38019-3237
(901) 476-7171
Mailing address
31 FIELDCREST DR, JACKSON, TN 38305-3052
(731) 925-0729
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2382
TN
Other
Enumeration date
10/21/2009
Last updated
02/21/2012
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