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

DAVID EDWARD JACKSON III, C.M.T.

Active Sole Proprietor

DAVID EDWARD JACKSON III, C.M.T. is a Massage Therapist healthcare provider located in LAKE STATION, Indiana. NPI 1275711350 is currently active in the NPPES registry. Verify at CMS.

Massage Therapist · LAKE STATION, IN

Registration Details

NPI Number
1275711350
Provider Type
Individual
Gender
Male
NPI Issued
Jan 31, 2008 (18.345502489999 yrs)
Last Updated
Jan 31, 2008
Sole Proprietor
Yes

Practice Information

Address
3321 E 35TH AVE
LAKE STATION, IN, 464053016
Browse IN providers · Browse ZIP 46405
Phone
2197144100
Primary Specialty
Massage Therapist
225700000X

Other Massage Therapist Providers in LAKE STATION, IN

Name Credential NPI
STEVEN SLAVO LMT 1396464947
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.