Individual
DR. GARRETT RODNEY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1258 BRYAN RD, O FALLON, MO 63366-3771
(636) 614-0401
Mailing address
138 QUAIL CREEK DR, WRIGHT CITY, MO 63390-3393
(636) 485-2077
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2012014933
MO
Other
Enumeration date
05/16/2012
Last updated
08/02/2012
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