Individual
MONTRELL NIGEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT,MTI,CPE
Contact information
Practice address
5959 FM 1960 RD W APT 1136, HOUSTON, TX 77069-4122
(713) 876-9034
Mailing address
5959 FM 1960 RD W APT 1136, HOUSTON, TX 77069-4122
(713) 876-9034
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT119368
TX
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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