SHANE LORAN JACKSON

OAKLAND, CA
NPI1548567571
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  23897)
Enumeration Date2011-02-28
Last Update Date2016-02-15
Business Address
-- SHANE LORAN JACKSON DPT
2844 SUMMIT ST STE 106
OAKLAND, CA 94609-3641
Phone number: 510-788-4535
Mailing Address
-- SHANE LORAN JACKSON DPT
2844 SUMMIT ST STE 106
OAKLAND, CA 94609-3641
Phone number: 510-788-4535
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