Jackson, Brandi

Jackson, Brandi is an individual health care provider with primary practice located at 2572 E South Weber Dr Ste 5 , South Weber UT 84405-9550. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Jackson, Brandi can be contacted via phone (801) 479-7045.

Contact Information

Primary practice address
2572 E South Weber Dr Ste 5 South Weber UT 84405-9550
Phone: (801) 479-7045
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1316406747
LBN Legal business name Jackson, Brandi
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2019
Last updated Mar 15th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316406747 NPPES
Utah Other 11189504-2401 PT LICENSE

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