Cortez Jackson

NPI 1588981443 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1588981443
Gender Male
Enumeration Date 04/30/2010
Last Updated 04/30/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
4109 HIGHWAY 98 W
SUMMIT MS, 39666-9132, US
Phone (601) 276-3909
Fax
Business Location
133 W GALLATIN ST
HAZLEHURST MS, 39083-3020, US
Phone
Fax
Toxanomy
Taxonomy Code 225200000X
License State Mississippi
License Number PTA4646
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According to our database, Cortez Jackson NPI is 1588981443, taxonomy code is 225200000X and license number is PTA4646, license state is located at Mississippi. Cortez Jackson physically located at 4109 Highway 98 W, Summit MS, 39666-9132. NPI Number Cortez Jackson has the Individual type.

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1588981443 NPI number is provided on an as is basis without warranty of any kind. 1588981443 is maintained by the National Plan & Provider Enumeration System. The contents of Cortez Jackson are for informational purposes only.