Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1001 RING AVE N, CANBY, MN 56220-1010
(507) 872-5300
(320) 839-4196
Mailing address
820 ROY ST, ORTONVILLE, MN 56278-1138
(320) 839-4087
(320) 839-4196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6996
MN
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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