Trevis Shantell Jackson

NPI #1073321659 in Fairburn, Georgia

Provider Information

NPI Number
1073321659
Entity Type
Individual
Name
Trevis Shantell Jackson
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Medicine & Rehabilitation
Enumeration Date
Dec 27, 2024
Last Updated
Dec 27, 2024

Practice Location

Address
7420 MISTYDAWN DR
State
Georgia
ZIP Code
30213-4330
Phone
(678) 361-8944

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant
Physical Medicine & Rehabilitation

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