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Amanda Jackson, ATC
NPI 1770017949 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1269 Barclay Cir Se
Marietta, GA 30060 - Phone
- (919) 370-0423
- Organisation at this address
- David Koentop
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
- Licence states on file
- GA, NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-04-14
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 Georgia