| NPI | 1295562890 |
|---|---|
| Professional Name | JOEL JACKSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: TX 2206) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: TX 2206) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-17 |