Organization
BACK IN ACTION PHYSICAL THERAPY & PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL FRANK JACKSON JR. PT, DPT (OWNER)
(478) 235-4441
Entity
Organization
Contact information
Practice address
1806 RUSSELL PKWY STE 1400, WARNER ROBINS, GA 31088-5781
(478) 235-4441
Mailing address
121 PARTRIDGE TRL, WARNER ROBINS, GA 31088-6592
(478) 235-4441
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114441375
INDIVIDUAL NPI
GA
Enumeration date
12/07/2020
Last updated
12/07/2020
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