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Contact Information

KATHLEEN G JACKSON, DPT
590 S WAKARA WAY
SALT LAKE CITY, UT84108-1200
 Phone: 801-587-7109
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
 

Neurology

2251N0400X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KATHLEEN G JACKSON · (Female)

NPI # 1720496326
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 07/27/2014
Last updated 07/27/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 9047266-2401
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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