Individual
JENNIFER O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 TANAGER WAY, HAMPSTEAD, NC 28443-3279
(910) 619-9320
Mailing address
103 TANAGER WAY, HAMPSTEAD, NC 28443-3279
(910) 619-9320
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14772
NC
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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