Individual
CAROLYN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9220 HIGHWAY 71 S STE 10, FORT SMITH, AR 72916-9151
(479) 763-1412
(479) 763-1425
Mailing address
9220 HIGHWAY 71 S STE 10, FORT SMITH, AR 72916-9151
(479) 763-7008
(479) 763-1425
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2019
AR
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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