Individual
KATHLEEN JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
98 HIGHWAY 150, SUITE 11, EL PRADO, NM 87529-7461
(575) 770-2001
Mailing address
140 LOWER LAS COLONIAS RD, EL PRADO, NM 87529-7461
(575) 770-2001
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3484
NM
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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