Individual
DR. TIMOTHY WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
8918 BLAKENEY PROFESSIONAL DR, SUITE 120, CHARLOTTE, NC 28277-6691
(704) 900-8960
Mailing address
8918 BLAKENEY PROFESSIONAL DR, SUITE 120, CHARLOTTE, NC 28277-6691
(704) 900-8960
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
2271
NC
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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