Diane Jackson

NPI #1992162259 in Utica, New York

Provider Information

NPI Number: 1992162259
Entity Type: Individual
Name: Diane Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jan 18, 2016
Last Updated: Jan 18, 2016

Practice Location

Address: 1676 SUNSET AVE
Address 2: PHYSICAL & OCCUPATIONAL THERAPY UNIT
City: Utica
State: New York
ZIP Code: 13502-5416
Phone: (315) 624-5400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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