MR. Shawn E Jackson, P.T.

NPI #1053577825 in Green Bay, Wisconsin

Provider Information

NPI Number: 1053577825
Entity Type: Individual
Name: MR. Shawn E Jackson, P.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Jul 31, 2008
Last Updated: May 21, 2015

Practice Location

Address: 2701 LARSEN RD
Address 2: SUITE 111
City: Green Bay
State: Wisconsin
ZIP Code: 54303-4863
Phone: (920) 883-2284

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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