Individual
JACKSON SANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4901 LAC DE VILLE BLVD UNIT D, ROCHESTER, NY 14618-5647
(585) 275-7379
Mailing address
4901 LAC DE VILLE BLVD UNIT D, ROCHESTER, NY 14618-5647
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
044568
NY
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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