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Shannon Jackson, PTA

Physical Therapy Assistant in Newport News, VA. Individual provider (NPI-1).

NPI number1407411366
StatusActive
Last updated in NPPESMay 7, 2019

Details

NPI
1407411366
Entity type
Individual (NPI-1)
Name
Shannon Jackson
Credential
PTA
Sex
Female
Sole proprietor
No
Enumeration date
May 7, 2019
Last updated
May 7, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant2306605329VAYes

Practice location

730 Thimble Shoals Blvd Ste 130
Newport News, VA 23606-4562

Phone 757-873-1554

Mailing address

730 Thimble Shoals Blvd Ste 130
Newport News, VA 23606-4562

Phone 757-873-1554

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Other Physical Therapy Assistant providers in Newport News, VA

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