Jackson, Justin

Jackson, Justin is an individual health care provider with primary practice located at 423 Great Oak Dr , Waite Park MN 56387-2507. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jackson, Justin can be contacted via phone (320) 281-5305.

Contact Information

Primary practice address
423 Great Oak Dr Waite Park MN 56387-2507
Phone: (320) 281-5305
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1760999841
LBN Legal business name Jackson, Justin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2018
Last updated Jan 10th, 2018 - 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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