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Individual
MS. TRACY L JACKSON
Active
Individual
MS. TRACY L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
04215
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 04215
PTA
OH
Enumeration date
06/16/2006
Last updated
07/13/2026
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