Individual
ERICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(571) 802-0363
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003650
GA
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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