Organization
JACKSON CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRETT RODNEY JACKSON D.C. (SOLE MEMBER)
(636) 614-0401
Entity
Organization
Contact information
Practice address
1258 BRYAN RD, O FALLON, MO 63366-3771
(636) 614-0401
(636) 614-4111
Mailing address
1258 BRYAN RD, O FALLON, MO 63366-3771
(636) 614-0401
(636) 614-4111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2012014933
MO
Other
Enumeration date
08/02/2012
Last updated
09/21/2012
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