NPI age
6 years
Enumerated 2019-09-03
● Active
Type 1 · Individual
Lamont Joseph Jack, PTA
Jack is 1 of 6 physical therapy assistant providers in Tucker and 1 of 1124 in Georgia.
Primary specialty
Physical Therapy Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-09-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1124 active physical therapy assistant providers in Georgia.
NPI age
6 years
↓ 3 yr below median (9 yr)
State licenses
1 state
6% of peers hold multiple states
Subspecialties
0
8% of peers hold subspecialties
NPI lifetime · 2019 → 2026
2019-09Enumerated in NPPES
2019
2026
Where they practice
Practice location
3888 Lavista Rd
Tucker, GA 300845142
Mailing address
3888 Lavista Rd
Tucker, GA 300845142
Specialties
-
Physical Therapy Assistant Primary(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or...
Practice context
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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