Individual
LUKE MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7744 SW 100TH RUN, LAKE BUTLER, FL 32054-6410
(904) 796-7726
Mailing address
7744 SW 100TH RUN, LAKE BUTLER, FL 32054-6410
(904) 796-7726
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
34560
FL
Other
Enumeration date
01/27/2026
Last updated
01/27/2026
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