Individual
VIRGINIA E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DAT, LAT, ATC
Contact information
Practice address
1209 RIFTWOOD LN, THOMASVILLE, GA 31792-7366
(229) 221-9916
Mailing address
1209 RIFTWOOD LN, THOMASVILLE, GA 31792-7366
(229) 221-9916
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL6273
FL
2255A2300X
Athletic Trainer
Primary
AT004142
GA
Other
Enumeration date
07/12/2019
Last updated
03/18/2024
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