MISS Kelly Nicole Jackson, PTA

NPI #1033365002 in Omaha, Nebraska

Provider Information

NPI Number: 1033365002
Entity Type: Individual
Name: MISS Kelly Nicole Jackson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 11, 2008
Last Updated: Aug 11, 2008

Practice Location

Address: 2085 N 120TH ST
Address 2: SUITE D8
City: Omaha
State: Nebraska
ZIP Code: 68164-3479
Phone: (402) 445-4335

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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