Individual
KRISTEN LORRAINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
720 YORKLYN RD STE 150, HOCKESSIN, DE 19707-8729
(302) 234-2288
Mailing address
720 YORKLYN RD STE 150, HOCKESSIN, DE 19707-8729
(302) 234-2288
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001280
DE
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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