Individual
KACI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
78 HOSPITAL RD, MACON, MS 39341-2490
(662) 726-4231
(601) 607-1345
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1362
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5726
MS
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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