Individual
ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
511 JERMOR LN STE 102, WESTMINSTER, MD 21157-6152
(410) 871-2494
(410) 861-5303
Mailing address
511 JERMOR LN STE 102, WESTMINSTER, MD 21157-6152
(141) 087-1249
(410) 861-5303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26889
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753702600
—
MD
Enumeration date
06/02/2018
Last updated
06/02/2018
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