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Individual

CHASITY JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1535 RIVER PARKWAY BLVD APT 208, SHREVEPORT, LA 71104-1803
(870) 665-9462
Mailing address
245 PEREGRINE WAY, BOSSIER CITY, LA 71112-2556
(870) 665-9462

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09698R
LA

Other

Enumeration date
04/23/2020
Last updated
11/01/2022
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