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Organization

DEBORAH JACKSON THERAPY ASSOCIATES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBORAH JACKSON (PRESIDENT)
(904) 342-5262
Entity
Organization

Contact information

Practice address
319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL 32092-3101
(904) 342-5262
(904) 217-3580
Mailing address
319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL 32092-3101
(904) 342-5262
(904) 217-3580

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT11000
FL
225100000X
Physical Therapist
PT20179
FL
225100000X
Physical Therapist
PT5569
FL
225100000X
Physical Therapist
PT7090
FL
225X00000X
Occupational Therapist
OT9478
FL
225XH1200X
Hand Occupational Therapist
OT7576
FL
235Z00000X
Speech-Language Pathologist
SA299
FL

Other

Enumeration date
05/22/2012
Last updated
06/28/2012
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