Provider Demographics
NPI:1548493471
Name:TOUSSAINT, JAMESON (PT)
Entity type:Individual
Prefix:
First Name:JAMESON
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 CHELSEA FALLS LN
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4534
Mailing Address - Country:US
Mailing Address - Phone:305-389-9357
Mailing Address - Fax:
Practice Address - Street 1:1664 CHELSEA FALLS LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4534
Practice Address - Country:US
Practice Address - Phone:305-389-9357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist