Jackson, Garrell Keithe
Jackson, Garrell Keithe is an sole proprietor health care provider with primary practice located at 3330 Cameron Park Dr Ste 200 , Cameron Park CA 95682-7652. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Jackson, Garrell Keithe can be contacted via phone (530) 621-4803.Contact Information
Primary practice address
3330 Cameron Park Dr Ste 200
Cameron Park CA 95682-7652
Phone: (530) 621-4803
Fax: (530) 621-2450
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 20634 | California |
Profile Details
| NPI number | 1326043399 |
|---|---|
| LBN Legal business name | Jackson, Garrell Keithe |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | May 5th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326043399 | NPPES |
| Other | DC0206340 | BLUE SHEILD | |
| Other | ZZZ61178Z | BLUE SHEILD |
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