NPI 1861215840

Andrea Jackson

Practitioner Rehabilitation Practitioner Fort Smith, AR

Practice location

Address: 2120 S Waldron Rd STE C, Fort Smith, AR 72903-3689
Phone: (479) 452-0424
Mailing address: 13364 Highway 219, Ozark, AR 72949-8939

Registered specialties

Rehabilitation Practitioner Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225400000X Licence PTA2294 (AR)

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Registry record

NPI: 1861215840
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Nov 2024
Record last updated: 6 Nov 2024

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.