Individual ProviderKristen D JacksonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address910 Frederick Rd, Catonsville, MD 21228-4516(410) 644-1880(667) 204-7000PECOS EnrollmentBased on the most recent information from CMS, provider Kristen D Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013148329Provider TypeIndividualFull NameJackson, Kristen DTitleMs.CredentialDPTGenderFemaleSole ProprietorNoEnumeration Date8/4/2009Last Updated10/17/2018Contact InformationPractice LocationPractice Address910 Frederick Rd, Catonsville, MD 21228-4516Phone(410) 644-1880Fax(410) 646-3623Mailing LocationMailing Address201 Defense Hwy, Ste 100, Annapolis, MD 21401-8902Phone(667) 204-7000Fax(443) 481-4151Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense22934Maryland