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1053672634
KIMBERLY JACKSON
PEACHTREE CITY, GA
NPI
1053672634
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT001774)
Enumeration Date
2012-05-31
Last Update Date
2012-05-31
Business Address
-- KIMBERLY JACKSON ATC
277 HIGHWAY 74 N STE 203
PEACHTREE CITY, GA 30269-1569
Phone number: 678-364-0337
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Mailing Address
-- KIMBERLY JACKSON ATC
8823 PRODUCTION LN
OOLTEWAH, TN 37363-6511
Phone number: 423-238-7217
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