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1154735611
COREY JACKSON
WICHITA, KS
NPI
1154735611
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Professional Name
COREY JACKSON
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: KS 11-04877)
Enumeration Date
2014-06-12
Last Update Date
2023-09-27
Business Address
COREY JACKSON D.P.T.
3460 N RIDGE RD STE 80
WICHITA, KS 67205-1223
Phone number: 316-202-0340
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Mailing Address
COREY JACKSON D.P.T.
1650 LYNDON FARM CT STE 300
LOUISVILLE, KY 40223-5005
Phone number: 316-263-0003
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