NPI 1134652456

Deshaun Jackson

Practitioner Physical Therapy Assistant Davison, MI

Practice location

Address: 709 Olivia Dr, Davison, MI 48423-1248
Phone: (810) 449-8321

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 5502004671 (MI)

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Registry record

NPI: 1134652456
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Apr 2017
Record last updated: 4 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.