Individual
TASHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3643 WALTON WAY EXT BLDG 4, AUGUSTA, GA 30909-6677
(762) 585-4589
Mailing address
2338 TRAVIS PINES DR, AUGUSTA, GA 30906-9428
(706) 339-4412
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT013040
GA
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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