Individual
JAVIER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2781 AIRWAYS BLVD, MEMPHIS, TN 38132-1104
(901) 291-1100
Mailing address
3421 CLOUDLAND DR, MEMPHIS, TN 38118-8125
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000010916
TN
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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