Jackson, Gerald Michael

Jackson, Gerald Michael is an individual health care provider with primary practice located at 2100 E Calvada Blvd , Pahrump NV 89048-5805. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Jackson, Gerald Michael can be contacted via phone (775) 727-7959.

Contact Information

Primary practice address
2100 E Calvada Blvd Pahrump NV 89048-5805
Phone: (775) 727-7959
Fax: (775) 727-7960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 0624 Nevada

Profile Details

NPI number 1730221029
LBN Legal business name Jackson, Gerald Michael
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Nov 20th, 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 1730221029 NPPES
Nevada MEDICAID 1730221029

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