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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336107408 | NPPES |
| Other | GE918Z | MEDICARE | |
| Other | Y5614 | MEDICARE |
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