Garrett Rodney Jackson, D.C. Valid NPI
Individual provider · Chiropractor · O Fallon, MO
- NPI
- 1922367515
- Type
- Individual (Type 1)
- Primary specialty
- Chiropractor
- Specialty group
- Chiropractic Providers
- Taxonomy code
- 111N00000X
- License number
- 2012014933 (MO)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2012-05-16
- Last updated
- 2012-08-02
Practice location
1258 Bryan Rd
O Fallon, MO 63366-3771
(636) 614-0401