Mark Wayne Jackson

NPI #1134755721 in Benbrook, Texas

Provider Information

NPI Number: 1134755721
Entity Type: Individual
Name: Mark Wayne Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Enumeration Date: Mar 16, 2020
Last Updated: Mar 16, 2020

Practice Location

Address: 8608 MARYS CREEK DR
City: Benbrook
State: Texas
ZIP Code: 76116-7624
Phone: (817) 420-2929

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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