Individual
DR. COREY LAMONT JACKSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1518 S POPLAR ST, PINE BLUFF, AR 71601-6249
(870) 535-4878
(870) 850-0199
Mailing address
3615 W HEPBURN ST, PINE BLUFF, AR 71603-2537
(870) 692-6618
(870) 540-0554
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1684
AR
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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