Individual
JERMIE MICHEAL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1114 COMMONWEALTH BLVD, TUPELO, MS 38804-9301
(662) 840-6366
Mailing address
1114 COMMONWEALTH BLVD, TUPELO, MS 38804-9301
(662) 840-6366
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PT-6667
MS
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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