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1174948038
TRACEY JACKSON
DAYTON, OH
NPI
1174948038
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: OH OT-002875)
Enumeration Date
2014-02-28
Last Update Date
2014-02-28
Business Address
-- TRACEY JACKSON
4801 SPRINGFIELD ST
DAYTON, OH 45431-1084
Phone number: 937-236-9969
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Mailing Address
-- TRACEY JACKSON
1060 MONTEGO DR
SPRINGFIELD, OH 45503-6243
Phone number: 937-206-3628
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