Jackson, Deborah A

Jackson, Deborah A is an sole proprietor health care provider with primary practice located at 319 W Town Pl Suite 5, St Augustine FL 32092-3101. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Jackson, Deborah A can be contacted via phone (904) 342-5262.

Contact Information

Primary practice address
319 W Town Pl Suite 5 St Augustine FL 32092-3101
Phone: (904) 342-5262
Fax: (904) 217-3580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT11000 Florida

Profile Details

NPI number 1336107408
LBN Legal business name Jackson, Deborah A
Credentials PHD,PT, OCS,CMP, ATC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2006
Last updated Oct 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336107408 NPPES
Other GE918Z MEDICARE
Other Y5614 MEDICARE

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