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Charles Jackson
NPI 1043655681 · on the registry since 2013 · sole proprietor
Practice
- Address
- 4856 W.12th
Suite 1
Cleveland, OH 44109 - Phone
- (440) 749-3019
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-11-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio