CHEVIS M JACKSON

CUMMING, GA
NPI1205413507
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: GA  PTA003382)
Enumeration Date2021-03-24
Last Update Date2021-03-24
Business Address
CHEVIS M JACKSON
125 SAMARITAN DR
CUMMING, GA 30040-2354
Phone number: 770-889-1644
Mailing Address
CHEVIS M JACKSON
1335 OAKSHYRE PL
LAWRENCEVILLE, GA 30043-6435
Phone number: 504-912-5169