Jackson, Richard

Jackson, Richard is an sole proprietor health care provider with primary practice located at 2650 West 2700 South , Syracuse UT 84075. He recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as his primary health care specialty. Jackson, Richard can be contacted via phone (801) 773-0200.

Contact Information

Primary practice address
2650 West 2700 South Syracuse UT 84075
Phone: (801) 773-0200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1124240197
LBN Legal business name Jackson, Richard
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 2nd, 2007
Last updated Jul 8th, 2007 - about 17 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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