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Individual

DR. JASON COLE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, DC

Contact information

Practice address
1211 DINAH SHORE BLVD, WINCHESTER, TN 37398-1107
(931) 967-6669
(931) 967-6606
Mailing address
1211 DINAH SHORE BLVD, WINCHESTER, TN 37398-1107
(931) 967-6669
(931) 967-6606

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0000002010
TN
363A00000X
Physician Assistant
Primary
2187
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4117134
TN BC/BS
TN
Enumeration date
09/20/2006
Last updated
10/13/2014
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