Individual
MRS. CHRISTINA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
316 N LEWIS ST, LAGRANGE, GA 30240-2740
(205) 478-1406
(866) 812-9807
Mailing address
733 AZALEA DR, LAGRANGE, GA 30240-1617
(120) 547-8140
(866) 812-9807
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
006706
GA
225X00000X
Occupational Therapist
Primary
OT006706
GA
Other
Enumeration date
03/22/2017
Last updated
11/29/2023
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