Tara Jackson, CPO

NPI #1851255764 in Portland, Maine

Provider Information

NPI Number: 1851255764
Entity Type: Individual
Name: Tara Jackson, CPO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CPO
Enumeration Date: Dec 15, 2025
Last Updated: Dec 15, 2025

Practice Location

Address: 1274 CONGRESS ST
City: Portland
State: Maine
ZIP Code: 04102-2111
Phone: (207) 774-1002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetist	224P00000X	Primary

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