Individual
JACKSON ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27599-0001
(919) 966-8596
(919) 843-5515
Mailing address
143 W FRANKLIN ST, CHAPEL HILL, NC 27516-2539
(919) 966-8596
(919) 843-5515
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2088
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411843
—
NC
Enumeration date
03/29/2007
Last updated
07/08/2007
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