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1225124712
OLYMPHIA ANECIA JACKSON
DOUGLASVILLE, GA
NPI
1225124712
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: GA pt007580)
Enumeration Date
2006-10-04
Last Update Date
2007-07-09
Business Address
-- OLYMPHIA ANECIA JACKSON MSPT
4352 MISSOULA PL
DOUGLASVILLE, GA 30135-8608
Phone number: 678-715-1544
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Mailing Address
-- OLYMPHIA ANECIA JACKSON MSPT
PO BOX 6867
DOUGLASVILLE, GA 30154-0032
Phone number: 678-715-1544
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