Individual
MR. HERMAN L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
PHYSICAL THERAPY OF HARLEM 1400 5TH AVE, NEW YORK CITY, NY 10026
(212) 996-3303
(212) 996-9686
Mailing address
24 E 109TH ST APT 1A, NEW YORK, NY 10029-3472
(347) 680-2272
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008098
NY
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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