Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MATTHEW JACKSON, DPT, MOT,ATC
Active Sole ProprietorMATTHEW JACKSON, DPT, MOT,ATC is a Athletic Trainer healthcare provider located in JENA, Louisiana. NPI 1992027775 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · JENA, LA
Registration Details
- NPI Number
- 1992027775
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 22, 2010 (16.293483960257 yrs)
- Last Updated
- Feb 22, 2010
- Licenses
-
07464 (LA)07464 (LA)07464 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
187 NINTH STJENA, LA, 713422780Browse LA providers · Browse ZIP 71342
- Phone
- 3189929200
- Fax
- 3189929280
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
- Additional Specialty
- Occupational Therapist
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.