Individual
ROBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3056 HEALTHY WAY STE 116, BIRMINGHAM, AL 35243-2435
(205) 783-5270
Mailing address
2823 GREYSTONE COMMERCIAL BLVD, BIRMINGHAM, AL 35242-2660
(205) 745-3660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH9551
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTH9551
LICENSE
AL
Enumeration date
10/11/2019
Last updated
10/11/2019
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