Provider Demographics
NPI:1063618627
Name:MCALLISTER, JACKSON ANDREW (MPT, OCS)
Entity type:Individual
Prefix:
First Name:JACKSON
Middle Name:ANDREW
Last Name:MCALLISTER
Suffix:
Gender:
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14400 E JEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5689
Mailing Address - Country:US
Mailing Address - Phone:303-887-9968
Mailing Address - Fax:
Practice Address - Street 1:14400 E JEWELL AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5689
Practice Address - Country:US
Practice Address - Phone:303-887-9968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9274225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist