Individual
MS. ELIZABETH A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIC. MASSAGE THERAPI
Contact information
Practice address
94 AUBURN ST STE 106, PORTLAND, ME 04103-2141
(207) 878-3003
(207) 878-3004
Mailing address
94 AUBURN ST, SUITE 106, PORTLAND, ME 04103-2141
(207) 878-3003
(207) 878-3004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT3127
ME
Other
Enumeration date
04/24/2008
Last updated
12/08/2008
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