JACOB S JACKSON

MOUNT VERNON, IL
NPI1982162905
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070024163)
Enumeration Date2019-03-08
Last Update Date2019-03-08
Business Address
Mr. JACOB S JACKSON DPT
4110 S WATER TOWER PL
MOUNT VERNON, IL 62864-6544
Phone number: 618-242-1100
Mailing Address
Mr. JACOB S JACKSON DPT
4110 S WATER TOWER PL
MOUNT VERNON, IL 62864-6544
Phone number: 618-242-1100
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