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Travis Jackson, ATC-L
NPI 1528345212 · on the registry since 2011 · sole proprietor
Practice
- Address
- 101 E 630 N Apt 20
Smithfield, UT 84335 - Phone
- (435) 760-1767
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-11-08
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 Utah