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1164551826
ASHIYA FAYE JACKSON
CHARLOTTE, NC
NPI
1164551826
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: IL 070010961)
Enumeration Date
2007-03-05
Last Update Date
2022-01-12
Business Address
Ms. ASHIYA FAYE JACKSON DPT, PCS
3205 FREEDOM DR
CHARLOTTE, NC 28208-2866
Phone number: 704-336-7100
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Mailing Address
Ms. ASHIYA FAYE JACKSON DPT, PCS
2621 KEZIAH RD
MATTHEWS, NC 28105-1993
Phone number: 773-592-6873
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