Toni M. Jackson
Kinesiotherapist Massage Therapist Rehabilitation Practitioner
4806 State St Home Office
East Saint Louis
, Illinois 62205-1355
Toni M. Jackson
Kinesiotherapist Massage Therapist Rehabilitation Practitioner
4806 State St Home Office
East Saint Louis
, Illinois 62205-1355
(618) 271-6247
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About
Features
Specialties
- Rehabilitation Practitioner
- Massage Therapist
- Kinesiotherapist
Languages spoken
- English
Location
First Address
- Toni M. Jackson
- 4806 State St Home Office
- East Saint Louis, IL
- Zip : 62205-1355
- Phone : (618) 271-6247
Second Address
- Toni M. Jackson
- 4806 State St Home Office
- East Saint Louis, IL
- Zip : 62205-1355
- Phone : (618) 225-2777
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 225400000X | Rehabilitation Practitioner | ||
| Y | 225700000X | Massage Therapist | 2005015267 | MO |
| N | 226300000X | Kinesiotherapist |
National Provider Identifier
| NPI | 1376871103 |
|---|---|
| Provider Name | Toni M. Jackson |
| First Address | East Saint Louis, IL 62205-1355 |
| Second Address | East Saint Louis, IL 62205-1355 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/12/2009 |
| Last Update Date | 25/02/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.