Russell Jackson, DPT

NPI #1902225519 in Payson, Utah

Provider Information

NPI Number: 1902225519
Entity Type: Individual
Name: Russell Jackson, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Apr 10, 2014
Last Updated: Apr 10, 2014

Practice Location

Address: 1551 N MAIN ST
City: Payson
State: Utah
ZIP Code: 84651-5015
Phone: (801) 465-5400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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