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

David Jackson Jr, PTA

Individual provider Physical Therapy Assistant · NPI 1104098904

David Jackson Jr, PTA is a Physical Therapy Assistant in Lake City, South Carolina. Licensed in South Carolina. Registered with an NPI since 2008.

Licensed in
SC
In the registry since
2008
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

258 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone: (843) 374-6198
Fax: (843) 374-6180
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 1706 (SC)

Record details

NPI number1104098904
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedApril 1, 2008
Last updated in NPPESApril 1, 2008

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