DR. Corey Lamont Jackson SR., D.C.

NPI #1659419075 in Pine Bluff, Arkansas

Provider Information

NPI Number: 1659419075
Entity Type: Individual
Name: DR. Corey Lamont Jackson SR., D.C.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Feb 1, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1518 S POPLAR ST
City: Pine Bluff
State: Arkansas
ZIP Code: 71601-6249
Phone: (870) 535-4878

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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