Individual
TERRENCE TERRELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 SOUTHAMPTON DR, ALEXANDRIA, LA 71303-3035
(318) 792-8400
Mailing address
1240 SOUTHAMPTON DR, ALEXANDRIA, LA 71303-3035
(318) 792-8400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA9563
LA
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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