Individual
BRANDON LEROY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4765 S. DURANGO DR., STE 106, LAS VEGAS, NV 89147
(702) 898-7633
(702) 898-6433
Mailing address
4765 S. DURANGO DR., STE 106, LAS VEGAS, NV 89147
(702) 898-7633
(702) 898-6433
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1365
NV
Other
Enumeration date
06/06/2006
Last updated
12/21/2021
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