Individual
ERIC JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1219 6TH AVE S, BIRMINGHAM, AL 35233
(205) 975-9256
Mailing address
607 OAKS DR, BIRMINGHAM, AL 35209-6985
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2170
AL
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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