Individual
HANNA MAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3824 S CARRIER PKWY, 470, GRAND PRAIRIE, TX 75052-6644
(972) 262-9972
(972) 262-9986
Mailing address
3824 S CARRIER PKWY, 470, GRAND PRAIRIE, TX 75052-6644
(972) 262-9972
(972) 262-9986
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2096038
TX
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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