Ty Alan Jackson, PTA

NPI #1679236871 in Durant, Oklahoma

Provider Information

NPI Number
1679236871
Entity Type
Individual
Name
Ty Alan Jackson, PTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
Oct 15, 2021
Last Updated
Oct 15, 2021

Practice Location

Address
1801 CHUKKA HINA
City
Durant
ZIP Code
74701-7117
Phone
(580) 920-2100

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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