Individual
JACKSON T GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
115 N WOLF RD, DES PLAINES, IL 60016-2111
(847) 924-6592
Mailing address
115 N WOLF RD, DES PLAINES, IL 60016-2111
(847) 924-6592
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007346
IL
Other
Enumeration date
11/25/2015
Last updated
11/25/2015
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