Individual
BLAKE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8132 CORDOVA RD, SUITE 102, CORDOVA, TN 38016-6005
(901) 751-0939
(901) 751-0332
Mailing address
8132 CORDOVA RD, SUITE 102, CORDOVA, TN 38016-6005
(901) 751-0939
(901) 751-0332
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0000002850
TN
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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