Individual
BRIANNA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7721 AIRPORT BLVD STE E120, MOBILE, AL 36608-5052
(251) 631-3680
(251) 631-3681
Mailing address
7075 PECAN GROVE AVE, THEODORE, AL 36582-2112
(251) 404-9176
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT6660
MS
225100000X
Physical Therapist
Primary
PTH9345
AL
Other
Enumeration date
06/05/2019
Last updated
11/08/2019
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