Individual
ERICA LEA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
13968 CYPRESS DR STE 1B, BAXTER, MN 56425-5904
(218) 822-3855
(218) 822-3854
Mailing address
624 NW 5TH ST, BRAINERD, MN 56401-2904
(218) 822-3855
(218) 822-3854
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4421
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088450200
—
MN
Enumeration date
01/04/2007
Last updated
01/04/2022
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