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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MISS IDA OLIVIA JACKSON, LAC, LMT

Active

MISS IDA OLIVIA JACKSON, LAC, LMT is a Acupuncturist healthcare provider located in KIRKWOOD, Missouri. NPI 1184022659 is currently active in the NPPES registry. Verify at CMS.

Acupuncturist · KIRKWOOD, MO

Registration Details

NPI Number
1184022659
Provider Type
Individual
Gender
Female
NPI Issued
Dec 15, 2014 (11.676145431372 yrs)
Last Updated
Dec 15, 2014
License
2013032932 (MO)

Practice Information

Address
103 N TAYLOR AVE
SUITE B
KIRKWOOD, MO, 631224360
Browse MO providers · Browse ZIP 63122
Phone
3146232302
Primary Specialty
Acupuncturist
171100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.