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General NPI Number Information
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NPI Number | 1518599786
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Entity Type | Individual
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Provider Name | MEGHAN E JACKSON DPT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 8836 TYLER BLVD
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City | MENTOR
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State | OH
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Zip | 44060-4361
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Country | US
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Telephone | 440-255-9553
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 WESTINGHOUSE DR STE 200
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-5238
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Country | US
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Telephone | 724-343-4060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT012159
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License Number State | OH
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