Individual
BRETT RANDALL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T., A.T.C.
Contact information
Practice address
13609 CALIFORNIA ST, SUITE 200, OMAHA, NE 68154-5260
(800) 456-5857
Mailing address
13609 CALIFORNIA ST, SUITE 200, OMAHA, NE 68154-5260
(800) 456-5857
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
157902
MA
225100000X
Physical Therapist
5501016594
MI
225100000X
Physical Therapist
PT27854
FL
225100000X
Physical Therapist
Primary
PT871604
DC
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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