Organization
MASSAGE REVOLUTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA MANNING LMT (PARTNER/OWNER)
(601) 918-1853
Entity
Organization
Contact information
Practice address
210 E CAPITOL ST, STE M-142, JACKSON, MS 39201-2306
(601) 918-1853
Mailing address
210 E CAPITOL ST STE M-142, JACKSON, MS 39201-2306
(601) 918-1853
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LMT 2025
MS
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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