Individual provider · Type 1 NPI

Ida Desiree Jackson

Physical Therapy Assistant · Macon, GA

NPI number 1639957434 Active

Practice location

291 Plantation Centre Dr N Apt 705
Macon, GA 31210-9249

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XPTA002042 (GA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1639957434

Ida Desiree Jackson's National Provider Identifier is 1639957434, issued on Sep 21, 2023. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Macon, GA. The record was last updated on Sep 21, 2023.