Joni Virginia Jackson
Prosthetic/Orthotic Supplier in Montgomery, AL. Individual provider (NPI-1).
NPI number1124981824
StatusActive
Last updated in NPPESDec 8, 2025
Details
- NPI
- 1124981824
- Entity type
- Individual (NPI-1)
- Name
- Joni Virginia Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 8, 2025
- Certification date
- Dec 8, 2025
- Last updated
- Dec 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
Practice location
6138 Atlanta HwyMontgomery, AL 36117-2800
Phone 334-273-9464
Mailing address
1540 Winona AveMontgomery, AL 36107-1432
Phone 334-657-7917
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