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Individual

DR. BRIAN MATTHEW JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1620 HAWTHORNE DR, STE 400, PLAINFIELD, IN 46168-2814
(765) 894-0500
(317) 454-1327
Mailing address
1620 HAWTHORNE DR, STE 400, PLAINFIELD, IN 46168-2814
(765) 894-0500
(317) 454-1327

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002510A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200990510
IN
Enumeration date
05/06/2010
Last updated
09/09/2018
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