Timothy Jackson
NPI #1073697017 in Bernalillo, New Mexico
Provider Information
- NPI Number
- 1073697017
- Entity Type
- Individual
- Name
- Timothy Jackson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Oct 25, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 872 S CAMINO DEL PUEBLO
- City
- Bernalillo
- State
- New Mexico
- ZIP Code
- 87004-5927
- Phone
- (505) 867-2383
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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