NPI 1407235922

Jody M Jackson

Practitioner Mechanotherapist West St Paul, MN

Practice location

Address: 33 Wentworth Ave E Suite 240, West St Paul, MN 55118-3431
Phone: (612) 770-7565

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 153830-6 (MN)

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Registry record

NPI: 1407235922
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2015
Record last updated: 26 Dec 2015

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.