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1669151841
TIYE JACKSON
MELBOURNE, FL
NPI
1669151841
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL 32771)
Enumeration Date
2023-07-14
Last Update Date
2023-07-14
Business Address
TIYE JACKSON PTA
3680 N WICKHAM RD
MELBOURNE, FL 32935-2337
Phone number: 321-255-5500
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Mailing Address
TIYE JACKSON PTA
5513 WINTER GARDEN PKWY
FORT PIERCE, FL 34951-2054
Phone number:
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