# ELIZABETH JACKSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023990561
- **Authorized official:** ELIZABETH JACKSON DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (912) 585-4211

## Contact information

- **Practice address:** 1446 HARPER ST, AUGUSTA, GA 30912-0012
- **Practice address phone:** (762) 375-2396
- **Mailing address:** 4304 CANDLEBERRY GDN, NORTH AUGUSTA, SC 29860-7203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2025
- **Last updated:** 09/23/2025