Individual
AMANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 PHILADELPHIA AVE, SHILLINGTON, PA 19607-2764
(610) 796-7022
Mailing address
500 PHILADELPHIA AVE, SHILLINGTON, PA 19607-2764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT022865
PA
Other
Enumeration date
11/04/2013
Last updated
10/04/2017
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