Individual
KELLI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
48R ENON ST., BEVERLY, MA 01915-1116
(978) 828-8468
Mailing address
14 ENON ST, 1ST FLOOR, BEVERLY, MA 01915-1116
(978) 828-8468
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4166
MA
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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