Individual
CAROLINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
291 PALMETTO ST, OVIEDO, FL 32765-9534
(407) 406-0629
Mailing address
291 PALMETTO ST, OVIEDO, FL 32765-9534
(407) 406-0629
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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