Individual
GINGER D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2109 N PATTERSON ST, STE A, VALDOSTA, GA 31602-2946
(229) 247-5225
(229) 241-8471
Mailing address
6543 GOOD HOPE CIR, NAYLOR, GA 31641-2052
(229) 247-5225
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002143
GA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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