Jackson, Carol Jean

Jackson, Carol Jean is an individual health care provider with primary practice located at 100 N 1St St Ste 103 Step Ahead Physical Therapy, Burbank CA 91502-1845. 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, Carol Jean can be contacted via phone (818) 846-7100.

Contact Information

Primary practice address
100 N 1St St Ste 103 Step Ahead Physical Therapy Burbank CA 91502-1845
Phone: (818) 846-7100
Fax: (818) 846-7101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT17651 California

Profile Details

NPI number 1538164827
LBN Legal business name Jackson, Carol Jean
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated May 21st, 2010 - about 15 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 1538164827 NPPES
California Other 20-0700404 TAX I.D. # FOR FACILITY
California Other OPT176510 TAX I.D. # FOR FACILITY

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