David Jackson Jr., PTA Valid NPI
Individual provider · Physical Therapy Assistant · Lake City, SC
- NPI
- 1104098904
- Type
- Individual (Type 1)
- Primary specialty
- Physical Therapy Assistant
- Specialty group
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy code
- 225200000X
- License number
- 1706 (SC)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2008-04-01
- Last updated
- 2008-04-01
Practice location
258 N Ron Mcnair Blvd
Lake City, SC 29560-2462
(843) 374-6198