Most Relevant Information
Provider Data
| NPI Number: | 1003381054 |
| Provider Name: | BRIANA JACKSON M OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/05/2018 |
| Last Updated: | 10/05/2018 |
Provider Practice Location
3120 4TH AVE NW
MINOT
ND
587032811
Practice Location Phone/Fax
| Phone: | 7017205355 |
| Fax: |
Provider Mailing Location
141 VALLEY AVE APT 102A
BURLINGTON
ND
587222026
Provider Mailing Phone/Fax
| Phone: | 7013912263 |
| Fax: |