Nathan Jackson Pllc

NPI #1477797033 in Tyler, Texas

Provider Information

NPI Number: 1477797033
Entity Type: Organization
Organization Name: Nathan Jackson Pllc
Primary Specialty: Physical Therapist
Enumeration Date: Apr 27, 2009
Last Updated: Aug 8, 2012

Practice Location

Address: 7922 S BROADWAY AVE
City: Tyler
State: Texas
ZIP Code: 75703-5242
Phone: (903) 388-8378

Authorized Official

Name: DAVID NATHAN JACKSON, P.T.
Title: PRESIDENT
Phone: (903) 388-8378

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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