Individual
JEFFREY S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1515 BROOKMERE WAY, CUMMING, GA 30040-1896
(734) 309-0244
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(610) 991-2034
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002748
GA
Other
Enumeration date
03/03/2007
Last updated
10/24/2023
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