Individual
DAVID NATHAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7922 S BROADWAY AVE, TYLER, TX 75703-5242
(903) 983-7775
Mailing address
PO BOX 6336, TYLER, TX 75711-6336
(903) 388-8378
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1156269
TX
Other
Enumeration date
09/23/2007
Last updated
09/04/2012
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