Individual
JACKSON L DIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
11940 W 119TH ST, OVERLAND PARK, KS 66213-2216
(913) 563-5500
Mailing address
5300 CLARE RD, SHAWNEE, KS 66226-2837
(913) 271-6587
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-08100
KS
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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