Individual
CODY JEFFERSON JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2835 CHILDRESS DR, ANDERSON, CA 96007-3563
(530) 378-0098
Mailing address
5874 AVERY WAY, REDDING, CA 96003-3095
(907) 602-2617
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/22/2021
Last updated
08/22/2021
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