MR. Herman L Jackson, PTA

NPI #1013423391 in New York City, New York

Provider Information

NPI Number: 1013423391
Entity Type: Individual
Name: MR. Herman L Jackson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Dec 21, 2017
Last Updated: Dec 21, 2017

Practice Location

Address: PHYSICAL THERAPY OF HARLEM 1400 5TH AVE
City: New York City
State: New York
ZIP Code: 10026
Phone: (212) 996-3303

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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