Individual
JENNA L. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 REYNOLDS ST, BRUNSWICK, GA 31520-6731
(912) 261-8906
Mailing address
148 LEESWOOD CIR, BRUNSWICK, GA 31525-2496
(404) 545-5197
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006258
GA
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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