Search › Virginia › 225100000X
Samuel Jackson
NPI 1588204721 · on the registry since 2020
Practice
- Address
- 10438 Iron Bridge Rd
Chester, VA 23831 - Phone
- (804) 796-1518
- Organisation at this address
- Tidewater Physical Therapy, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 10
Additional practice sites
- 101 Manning Dr, Chapel Hill, NC
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Also registered as
- 225100000X
- Licence states on file
- VA, NC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-09-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia