Individual
LEO JACKSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1000 WHITE ST SW STE 300, ATLANTA, GA 30310-2634
(470) 905-2800
(470) 905-2801
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 350-2644
(586) 541-3735
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017004
GA
Other
Enumeration date
02/14/2024
Last updated
02/17/2026
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