Individual
OLIVIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 ROCKSIDE RD, INDEPENDENCE, OH 44131-2172
(216) 986-4000
Mailing address
5001 ROCKSIDE RD, INDEPENDENCE, OH 44131-2172
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT005957
OH
Other
Enumeration date
03/31/2014
Last updated
01/15/2020
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