MRS. Matilda Nelms Jackson, PTA

NPI #1821210907 in Vidalia, Georgia

Provider Information

NPI Number: 1821210907
Entity Type: Individual
Name: MRS. Matilda Nelms Jackson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: May 2, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 136 KENDALL PALMER RD
City: Vidalia
State: Georgia
ZIP Code: 30474-8200
Phone: (912) 538-9832

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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