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MS. DIANNE RUTH JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1001 BLYTHE BLVD, SUITE 200, CHARLOTTE, NC 28203-5863
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
4275
NC

Other

Enumeration date
11/29/2005
Last updated
05/13/2010
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