Individual
DR. CHAD WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
822 S WALNUT ST, MARYVILLE, MO 64468-2565
(660) 562-2705
(660) 562-7967
Mailing address
822 S WALNUT ST, MARYVILLE, MO 64468-2565
(660) 562-2705
(660) 562-7967
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2001019379
MO
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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