Individual
MS. KAYLA MACKENZIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
600 GREENLAWN DR APT 2201, COLUMBIA, SC 29209-0506
(803) 477-8663
Mailing address
600 GREENLAWN DR APT 2201, COLUMBIA, SC 29209-0506
(803) 477-8663
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.6931
SC
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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