Individual
DR. MEGHAN REID JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Contact information
Practice address
777 SUMMER BREEZE DR, BATON ROUGE, LA 70810-6187
(314) 922-8532
Mailing address
777 SUMMER BREEZE DR, BATON ROUGE, LA 70810-6187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200256
LA
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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