Individual
MR. CHAZERAY MONTEYA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1301 KENSINGTON PLACE APT B, ASHEVILLE, NC 28803-2393
(828) 275-6688
Mailing address
1301 KENSINGTON PL APT B, ASHEVILLE, NC 28803-2393
(828) 275-6688
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2306604367
VA
225200000X
Physical Therapy Assistant
Primary
A5816
NC
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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