Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alexia Dominique Jackson, LAT, ATC

Individual provider Athletic Trainer · NPI 1629992524

Alexia Dominique Jackson, LAT, ATC is an Athletic Trainer in East Lansing, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2026
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

223 Kalamazoo St
East Lansing, MI 48824-5400
Phone: (517) 355-9710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2601003099 (MI)

Record details

NPI number1629992524
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT , ATC
Sole proprietorYes
NPI enumeratedAugust 5, 2026
Last updated in NPPESAugust 5, 2026
Certification dateAugust 5, 2026

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