Individual
JENNIFER WHITENER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2778 COUNTRY CLUB DR, HAMPSTEAD, NC 28443-8028
(910) 270-1443
Mailing address
409 PHAESON PL, ELIZABETH CITY, NC 27909-7765
(828) 234-3680
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2526
NC
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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