SearchKansas104100000X

Joshua Jackson

NPI 1164281085 · on the registry since 2024 · sole proprietor

Practice

Address
500 Main Place, 500 N Main St Ste 156
Newton, KS 67114
Phone
(316) 202-4414

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
KS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-03-14

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 Kansas