National Provider Identifier
Daile M Jackson, PT, DPT
Daile M Jackson, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Jamestown, NY and a listed phone number of (716) 665-1166.
Profile Overview
- NPI
- 1306134267
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- July 13, 2011
- Last Updated
- January 30, 2022
Practice Location
- 774 Fairmount Ave
- Jamestown, NY 14701-2609
Phone: (716) 665-1166
Mailing Address
- 3266 Fluvanna Avenue Ext
- Fluvanna, NY 14701-9706
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1306134267
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Daile
- Middle Name
- M
- Credential
- PT, DPT
- Provider Other Last Name
- Johnson
- Provider Other First Name
- Daile
- Provider Other Middle Name
- M
- Provider Other Credential Text
- PT, DPT
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 3266 Fluvanna Avenue Ext
- Mailing City
- Fluvanna
- Mailing State
- NY
- Mailing ZIP Code
- 14701-9706
- Mailing Country
- US
- Mailing Phone
- (716) 665-0773
- Practice Street Address
- 774 Fairmount Ave
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-2609
- Practice Country
- US
- Practice Phone
- (716) 665-1166
- Practice Fax
- (866) 902-1160
- Enumeration Date
- July 13, 2011
- Last Updated
- January 30, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 30, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)
- Other Identifiers
- 03424691 (NY)