Individual
BEVERLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
665 GAINES SCHOOL RD, ATHENS, GA 30605-3127
(706) 369-8115
(706) 369-8116
Mailing address
665 GAINES SCHOOL RD, ATHENS, GA 30605-3127
(706) 369-8115
(706) 369-8116
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004284
GA
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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