Jackson, Tracy L

Jackson, Tracy L is an individual health care provider with primary practice located at 2500 Quantum Lakes Dr Suite 108, Boynton Beach FL 33426-8324. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Jackson, Tracy L can be contacted via phone (561) 244-3627.

Contact Information

Primary practice address
2500 Quantum Lakes Dr Suite 108 Boynton Beach FL 33426-8324
Phone: (561) 244-3627
Fax: (561) 244-9627
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 04215 Ohio

Profile Details

NPI number 1891739868
LBN Legal business name Jackson, Tracy L
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 8th, 2007 - about 17 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 1891739868 NPPES
Ohio Other PTA 04215 PTA

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