Individual
MRS. LINDA CAROL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9200 S COUNTY ROAD 300 W, MUNCIE, IN 47302-8833
(765) 759-8664
Mailing address
9200 S COUNTY ROAD 300 W, MUNCIE, IN 47302-8833
(765) 759-8664
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002171A
IN
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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