Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3857 | OH |
NPI | 1417133471 |
---|---|
Provider Name | Karen Achie Jackman |
First Address | Columbus, OH 43229-3568 |
Second Address | Columbus, OH 43229-3568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2008 |
Last Update Date | 21/01/2008 |