OLYMPHIA ANECIA JACKSON

DOUGLASVILLE, GA
NPI1225124712
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2251P0200X Physical Therapist, Pediatrics
(Licence: GA  pt007580)
Enumeration Date2006-10-04
Last Update Date2007-07-09
Business Address
-- OLYMPHIA ANECIA JACKSON MSPT
4352 MISSOULA PL
DOUGLASVILLE, GA 30135-8608
Phone number: 678-715-1544
Mailing Address
-- OLYMPHIA ANECIA JACKSON MSPT
PO BOX 6867
DOUGLASVILLE, GA 30154-0032
Phone number: 678-715-1544