Individual
ARLYN RIVERA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
111 NATURE WALK PARKWAY STE 101, ST AUGUSTINE, FL 32092
(904) 230-7761
Mailing address
206 12TH ST, ST AUGUSTINE, FL 32084-1413
(904) 377-5559
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT20823
FL
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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