Individual
JOSHUA DARNELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
801 HARDING BLVD, BATON ROUGE, LA 70807-5326
(817) 312-9960
(225) 771-4221
Mailing address
1925 N 3RD ST APT 327, BATON ROUGE, LA 70802-5174
(817) 312-9960
(225) 771-4221
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
301245
LA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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