Organization
BRANDON JACKSON, P T
Active
Other names
Jackson Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON LEROY JACKSON P.T. (OWNER)
(702) 898-7633
Entity
Organization
Contact information
Practice address
4765 S. DURANGO DR., STE 106, LAS VEGAS, NV 89147
(702) 898-7633
(702) 898-6433
Mailing address
4765 S. DURANGO DR., STE 106, LAS VEGAS, NV 89147
(702) 898-7633
(702) 898-6433
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1365
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506016
—
NV
Enumeration date
06/30/2006
Last updated
08/12/2025
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