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Individual

ALEC JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8914 BRIARWOOD DR, SEMINOLE, FL 33772-2807
(727) 644-0479
Mailing address
8914 BRIARWOOD DR, SEMINOLE, FL 33772-2807

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28190
FL

Other

Enumeration date
03/07/2023
Last updated
03/07/2023
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