Individual
ISABELLA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8540 SCARBOROUGH DR STE 200, COLORADO SPRINGS, CO 80920-7513
(719) 630-7500
Mailing address
8540 SCARBOROUGH DR STE 200, COLORADO SPRINGS, CO 80920-7513
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0014619
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014619
COLORADO STATE LICENSE
CO
Enumeration date
01/07/2020
Last updated
01/07/2020
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