Individual
CHERYL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Mailing address
2710 E RAMSEY AVE, CUDAHY, WI 53110-2409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9922-024
WI
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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