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1104204668
WAYNE JACKSON
ELLICOTT CITY, MD
NPI
1104204668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MD 25338)
Enumeration Date
2015-05-15
Last Update Date
2015-12-04
Business Address
Dr. WAYNE JACKSON DPT
10300B BALTIMORE NATIONAL PIKE
ELLICOTT CITY, MD 21042-2128
Phone number: 410-988-5171
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Mailing Address
Dr. WAYNE JACKSON DPT
10300-B BALTIMORE NATIONAL PIKE
ELLICOTT CITY, MD 21042-2128
Phone number: 410-988-5171
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