NPI 1205413507

Chevis M Jackson

Practitioner Physical Therapy Assistant Cumming, GA

Practice location

Address: 125 Samaritan Dr, Cumming, GA 30040-2354
Phone: (770) 889-1644
Mailing address: 1335 Oakshyre Pl, Lawrenceville, GA 30043-6435

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA003382 (GA)

Other Physical Therapy Assistant providers in Georgia →

Registry record

NPI: 1205413507
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Mar 2021
Record last updated: 24 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.