Jody M Jackson

NPI #1407235922 in West St Paul, Minnesota

Provider Information

NPI Number: 1407235922
Entity Type: Individual
Name: Jody M Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Mechanotherapist
Enumeration Date: May 29, 2015
Last Updated: Dec 26, 2015

Practice Location

Address: 33 WENTWORTH AVE E
Address 2: SUITE 240
City: West St Paul
State: Minnesota
ZIP Code: 55118-3431
Phone: (612) 770-7565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Mechanotherapist	172M00000X	Primary

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