Shannon Jackson, PTA
NPI #1407411366 in Newport News, Virginia
Provider Information
- NPI Number
- 1407411366
- Entity Type
- Individual
- Name
- Shannon Jackson, PTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- May 7, 2019
- Last Updated
- May 7, 2019
Practice Location
- Address
- 730 THIMBLE SHOALS BLVD STE 130
- City
- Newport News
- State
- Virginia
- ZIP Code
- 23606-4562
- Phone
- (757) 873-1554
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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