CORTEZ JACKSON

SUMMIT, MS
NPI1588981443
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MS  PTA4646)
Enumeration Date2010-04-30
Last Update Date2010-04-30
Business Address
-- CORTEZ JACKSON
4109 HIGHWAY 98 W
SUMMIT, MS 39666-9132
Phone number: 601-276-3909
Mailing Address
-- CORTEZ JACKSON
133 W GALLATIN ST
HAZLEHURST, MS 39083-3020
Phone number:
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