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Individual

MIKAELA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
500 N JUDGE ELY BLVD APT 8-102, ABILENE, TX 79601-6530
(251) 623-0646
Mailing address
500 N JUDGE ELY BLVD APT 8-102, ABILENE, TX 79601-6530

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/12/2021
Last updated
04/12/2021
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