| NPI | 1932837408 |
|---|---|
| Other Name | JACKSON LAMAR |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT016077) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH11472) |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-09-01 |