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1447762844
COLLEEN JACKSON
LUBBOCK, TX
NPI
1447762844
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: TX 212955)
Enumeration Date
2017-10-26
Last Update Date
2017-10-26
Business Address
COLLEEN JACKSON COTA/L
8011 ELKHART AVE
LUBBOCK, TX 79424-2615
Phone number: 518-312-7513
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Mailing Address
COLLEEN JACKSON COTA/L
6502 SLIDE RD STE 204
LUBBOCK, TX 79424-1311
Phone number: 806-686-0429
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