Jackson, Ty Alan

Jackson, Ty Alan is an individual health care provider with primary practice located at 1801 Chukka Hina , Durant OK 74701-7117. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Jackson, Ty Alan can be contacted via phone (580) 920-2100.

Contact Information

Primary practice address
1801 Chukka Hina Durant OK 74701-7117
Phone: (580) 920-2100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 3010 Oklahoma

Profile Details

NPI number 1679236871
LBN Legal business name Jackson, Ty Alan
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2021
Last updated Oct 15th, 2021 - about 4 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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