Brandon T. Jackson, D.C. Valid NPI
Individual provider · Chiropractor · O Fallon, MO
- NPI
- 1578896031
- Type
- Individual (Type 1)
- Primary specialty
- Chiropractor
- Specialty group
- Chiropractic Providers
- Taxonomy code
- 111N00000X
- License number
- 2011014558 (MO)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2009-09-15
- Last updated
- 2022-04-02
Practice location
5551 Winghaven Blvd Ste 20
O Fallon, MO 63368-3618
(636) 614-0401