Individual
CHANELL MONIQUE JACKSON-BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9550 MEYER FOREST DR APT 1014, HOUSTON, TX 77096-4361
(773) 617-9046
Mailing address
9550 MEYER FOREST DR APT 1014, HOUSTON, TX 77096-4361
(773) 617-9046
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2173678
TX
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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