Individual
ANDREA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Mailing address
3801 S WATER TOWER PL APT 215, MOUNT VERNON, IL 62864-6591
(618) 918-1226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070019734
IL
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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