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1740673805
LORIE G JACKSON
LOUISVILLE, KY
NPI
1740673805
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: KY A02653)
Enumeration Date
2015-03-13
Last Update Date
2015-03-13
Business Address
MS. LORIE G JACKSON PTA
1800 BLUEGRASS AVE
LOUISVILLE, KY 40215-1130
Phone number: 502-361-2301
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Mailing Address
MS. LORIE G JACKSON PTA
106 ADA AVE
SHELBYVILLE, KY 40065-1432
Phone number: 502-257-2497
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