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Contact Information

KEITH R JACKSON, OTR/L
600 NORTH BLVD W
SUITE D
LEESBURG, FL34748-5063
 Phone: 352-787-9300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KEITH R JACKSON · (Male)

NPI Number 1003009937
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 08/23/2007
Last updated 08/23/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • FL License # OT9471
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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