Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Brandon Travon Jackson, DPT

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083163521

Brandon Travon Jackson, DPT is a Student in an Organized Health Care Education/Training Program in Marietta, Georgia. Practices as a sole proprietor. Licensed in Georgia and North Carolina.

Licensed in
GA, NC
In the registry since
2016
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1395 S Marietta Pkwy SE Ste 212
Marietta, GA 30067-7832
Phone: (770) 615-7900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT015749 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NC)

Record details

NPI number1083163521
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedSeptember 26, 2016
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024
Mailing address3360 Ohara Dr N, Macon, GA 31206-3832

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