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Individual

AMY JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1609 N SUMMIT ST, TOLEDO, OH 43604-1806
(419) 671-0001
(419) 539-0288
Mailing address
2315 STONYBROOK BLVD, SYLVANIA, OH 43560-8905

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-10851
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000362244
ANTHEM PROVIDER NUMBER
OH
Enumeration date
02/20/2007
Last updated
05/22/2025
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