Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN GAINOR JACKSON, PT, DPT
ActiveETHAN GAINOR JACKSON, PT, DPT is a Physical Therapy Assistant healthcare provider located in LAWRENCEVILLE, Georgia. NPI 1891210456 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · LAWRENCEVILLE, GA
Registration Details
- NPI Number
- 1891210456
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 4, 2017 (9.0406006765955 yrs)
- Last Updated
- Aug 4, 2017
- License
-
PT013032 (GA)
Practice Information
- Address
-
455 PHILIP BLVD BLDG 100-160LAWRENCEVILLE, GA, 300468767Browse GA providers · Browse ZIP 30046
- Phone
- 6789850238
- Fax
- 6789850136
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in LAWRENCEVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| MRS. CAROLE L CUNNINGHAM | PT | 1881635373 |
| ERIC STEVEN ERHARDT | PT | 1730117185 |
| MATTHEW J WINTERS | DPT | 1124053194 |
| MALYNDA ANN CARRUTH | PT, DPT | 1366559304 |
| TAMMY IVIE | PT | 1548378672 |
| NISHITH OZA | PT | 1063511749 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.