Individual
DARON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
122 EAGLES LANDING PKWY, SUITE A, STOCKBRIDGE, GA 30281-5091
(678) 289-0525
(678) 289-0529
Mailing address
5475 HILLTOP PASS, FAIRBURN, GA 30213-7933
(770) 892-4938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008120
LICENSE#
GA
Enumeration date
11/03/2006
Last updated
11/04/2008
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