Individual
MS. EARLENE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7404 EXECUTIVE PL, #300B, LANHAM, MD 20706-2268
(301) 599-9500
Mailing address
7404 EXECUTIVE PL, #300B, LANHAM, MD 20706-2268
(301) 599-9500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23062
MD
Other
Enumeration date
03/27/2012
Last updated
02/28/2014
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