Individual
DAILEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3530 PAN AMERICAN FWY NE STE D, ALBUQUERQUE, NM 87107-4793
(505) 888-4469
Mailing address
3530 PAN AMERICAN FWY NE STE D, ALBUQUERQUE, NM 87107-4793
(505) 889-4469
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3685
NM
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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