Individual
NAKEA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
Mailing address
2014 JASICA CT, DEFIANCE, OH 43512-5800
(419) 789-3725
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
130311
AK
225200000X
Physical Therapy Assistant
PTA011672
OH
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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