IDA DESIREE JACKSON

MACON, GA
NPI1639957434
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: GA  PTA002042)
Enumeration Date2023-09-21
Last Update Date2023-09-21
Business Address
IDA DESIREE JACKSON
291 PLANTATION CENTRE DR N APT 705
MACON, GA 31210-9249
Phone number: 478-447-7052
Mailing Address
IDA DESIREE JACKSON
291 PLANTATION CENTRE DR N APT 705
MACON, GA 31210-9249
Phone number: 478-447-7052
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