Individual
DAVID ANDREW JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
326 N INDIANA AVE, SELLERSBURG, IN 47172-1223
(812) 246-8975
(812) 246-8977
Mailing address
326 N INDIANA AVE, SELLERSBURG, IN 47172-1223
(812) 246-8975
(812) 246-8977
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002999
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042777
ANTHEM PIN #
IN
01
—
64-00191
UHC PIN #
IN
Enumeration date
02/13/2006
Last updated
07/09/2007
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