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1720541550
DOMINIC A JACKSON
AUSTIN, TX
NPI
1720541550
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: TX 1315070)
Enumeration Date
2019-04-09
Last Update Date
2019-04-09
Business Address
Dr. DOMINIC A JACKSON DPT
16210 BRAESGATE DR
AUSTIN, TX 78717-4850
Phone number: 408-568-1586
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Mailing Address
Dr. DOMINIC A JACKSON DPT
16210 BRAESGATE DR
AUSTIN, TX 78717-4850
Phone number: 408-568-1586
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