Action Jackson Physical Therapy, P.c.

NPI #1255700555 in Oakland, California

Provider Information

NPI Number: 1255700555
Entity Type: Organization
Organization Name: Action Jackson Physical Therapy, P.c.
Primary Specialty: Physical Therapist
Enumeration Date: Sep 17, 2015
Last Updated: Sep 17, 2015

Practice Location

Address: 2844 SUMMIT ST
Address 2: SUITE 106
City: Oakland
State: California
ZIP Code: 94609-3637
Phone: (510) 763-3005

Authorized Official

Name: MR. SHANE LORAN JACKSON, DPT
Title: OWNER/PHYSICAL THERAPIST
Phone: (510) 292-5385

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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