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Individual

WILLIAM BRADLEY JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
176 DIVISION ST, GREAT BARRINGTON, MA 01230-1179
(413) 528-4289
Mailing address
176 DIVISION ST, GREAT BARRINGTON, MA 01230-1179

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8151
MA

Other

Enumeration date
08/14/2007
Last updated
08/14/2007
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