Individual
WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1204 CREEKSTONE DR, BATAVIA, OH 45103-7565
(256) 343-4127
Mailing address
1204 CREEKSTONE DR, BATAVIA, OH 45103-7565
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA011873
OH
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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