| Leo Jackson Iii, PT | |
|
1000 White St Sw Ste 300, Atlanta, GA 30310-2634 | |
| (470) 905-2800 | |
| (470) 905-2801 |
| Full Name | Leo Jackson Iii |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1000 White St Sw Ste 300, Atlanta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588429161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT017004 (Georgia) | Primary |
| Provider Name | Team Rehabilitation Services Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1508538158 PECOS PAC ID: 2264479518 Enrollment ID: O20211115001221 |
| Mailing Address | Practice Location Address |
|---|---|
| Leo Jackson Iii, PT 33900 Harper Ave Ste 104, Clinton Twp, MI 48035-4258 Ph: (586) 350-2644 | Leo Jackson Iii, PT 1000 White St Sw Ste 300, Atlanta, GA 30310-2634 Ph: (470) 905-2800 |
Mrs. Joel Adrianna Bruno, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 390 Stovall St Se, Apt 3109, Atlanta, GA 30316 Phone: 404-719-2515 | |
Erin G Kent, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1867 Harvard Ave, Atlanta, GA 30337 Phone: 404-835-4321 Fax: 404-835-4320 | |
Taylor Morris Gayle, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 860 Johnson Fy Rd Ne, Ste 100, Atlanta, GA 30342 Phone: 404-252-5545 Fax: 404-252-5511 | |
Elizabeth Ashley Smith, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 800 Peachtree St Ne Ste E2, Atlanta, GA 30308 Phone: 404-254-3319 | |
Spencer Edward Kasmere, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 925 Garrett St Se Ste J, Atlanta, GA 30316 Phone: 404-624-5407 Fax: 404-624-5409 | |
Natalie Muniz, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3280 Howell Mill Rd Nw Ste 303, Atlanta, GA 30327 Phone: 470-300-6030 Fax: 470-300-6031 | |
Ogoluwakitan Cal Lawanson, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3200 Downwood Cir Nw Ste 700, Atlanta, GA 30327 Phone: 404-355-0743 |