Individual
HANNAH JACQUELINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
KROONTJE HEALTHCARE CENTER, 100 LITTON LANE, BLACKSBURG, VA 24060
(540) 443-3437
Mailing address
804 PETRA PASS, BLACKSBURG, VA 24060-8772
(540) 808-9132
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604661
VA
Other
Enumeration date
01/04/2019
Last updated
05/07/2021
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