Jackson, Tia

Jackson, Tia is an individual health care provider with primary practice located at 323 S 18Th Ave , Sturgeon Bay WI 54235-1401. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Jackson, Tia can be contacted via phone (920) 746-0410.

Contact Information

Primary practice address
323 S 18Th Ave Sturgeon Bay WI 54235-1401
Phone: (920) 746-0410
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 1559-39 Wisconsin

Profile Details

NPI number 1649725938
LBN Legal business name Jackson, Tia
Credentials MS, LAT, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2016
Last updated Feb 19th, 2019 - about 7 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.

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