Organization
PROCESS PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASMINE JACKSON (PT, DPT)
(301) 531-5347
Entity
Organization
Contact information
Practice address
3807 RHODE ISLAND AVE APT 322, BRENTWOOD, MD 20722-1475
(301) 531-5347
Mailing address
3807 RHODE ISLAND AVE APT 322, BRENTWOOD, MD 20722-1475
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26346
PT LISENCE #
MD
Enumeration date
02/02/2021
Last updated
02/02/2021
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