Individual
CHASITY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5440 PEACHTREE BLVD, CHAMBLEE, GA 30341-2255
(470) 719-0090
(470) 719-0091
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA005168
GA
Other
Enumeration date
05/30/2025
Last updated
08/01/2025
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