Susan Jackson, PT

NPI #1609042639 in West Melbourne, Florida

Provider Information

NPI Number: 1609042639
Entity Type: Individual
Name: Susan Jackson, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Apr 30, 2008
Last Updated: Apr 30, 2008

Practice Location

Address: 3275 SOFT BREEZE CIR
City: West Melbourne
State: Florida
ZIP Code: 32904-7710
Phone: (321) 223-7570

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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