Chanda D'Riece Jackson, P.T.

Physical Therapist · Thomas, OK

Individual Active NPI

NPI number 1063440436

Practice location

100 S 2ND Street
Thomas, OK 73669
Phone
(580) 661-2639
Fax
(580) 661-2640

Open in Google Maps

NPI record

NPI
1063440436
Entity type
Individual (Type 1)
Enumeration date
June 28, 2006
Last updated
March 18, 2014
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapist Primary 225100000X 3728 OK

Mailing address

PO Box 797
Thomas, OK 73669-0797
Phone
(580) 661-2639
Fax
(580) 661-2640

About Chanda Jackson

Chanda D'Riece Jackson, P.T. is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapist (code 225100000X). The practice location is 100 S 2ND Street, Thomas, OK 73669. The NPI number 1063440436 was assigned on June 28, 2006 and the record was last updated on March 18, 2014.

Chanda Jackson lists a license in the registry: #3728 (OK) for Physical Therapist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Chanda D'Riece Jackson, P.T.?

The NPI number is 1063440436.

What is the phone number of Chanda Jackson?

The phone number listed for the practice location is (580) 661-2639.

Where is Chanda Jackson located?

100 S 2ND Street, Thomas, OK 73669.

What is the taxonomy code for Chanda Jackson?

The primary taxonomy code is 225100000X – Physical Therapist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Physical Therapist providers in Thomas

All Physical Therapist providers in Thomas, OK →