Individual
ELIZABETH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1446 HARPER ST, AUGUSTA, GA 30912-0012
(912) 585-4211
Mailing address
4304 CANDLEBERRY GDN, NORTH AUGUSTA, SC 29860-7203
(912) 585-4211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017811
GA
Other
Enumeration date
09/29/2025
Last updated
10/24/2025
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