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1083392252
TAWANA T JACKSON
BRONX, NY
NPI
1083392252
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: TX 1378139)
Enumeration Date
2023-07-07
Last Update Date
2024-05-02
Business Address
TAWANA T JACKSON PT, DPT
1250 WATERS PL
BRONX, NY 10461-2720
Phone number: 718-409-9444
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Mailing Address
TAWANA T JACKSON PT, DPT
5231 WILD BLACKBERRY DR
KINGWOOD, TX 77345-2076
Phone number: 910-465-1484
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