MICHELLE DIANNE JACKSON

LARGO, MD
NPI1235263963
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MD  15783)
Enumeration Date2007-03-15
Last Update Date2007-07-08
Business Address
-- MICHELLE DIANNE JACKSON PT
1221 MERCANTILE LN
LARGO, MD 20774-5374
Phone number: 301-618-5552
Mailing Address
-- MICHELLE DIANNE JACKSON PT
2101 E JEFFERSON ST KAISER PERMANENTE ATTN:SANJAY MATHUR 3 W DATA MNMGT DPT
ROCKVILLE, MD 20852-4908
Phone number: 301-816-7446
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