David Jackson Jr., PTA
NPI #1104098904 in Lake City, South Carolina
Provider Information
- NPI Number
- 1104098904
- Entity Type
- Individual
- Name
- David Jackson Jr., PTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Apr 1, 2008
- Last Updated
- Apr 1, 2008
Practice Location
- Address
- 258 N RON MCNAIR BLVD
- City
- Lake City
- State
- South Carolina
- ZIP Code
- 29560-2462
- Phone
- (843) 374-6198
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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