Individual
KRISTINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
27169 CALIFORNIA HIGHWAY 189,, SUITE 2, BLUE JAY, CA 92317
(909) 486-9705
(909) 323-0215
Mailing address
PO BOX 2392, LAKE ARROWHEAD, CA 92352-2392
(909) 486-9648
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
94145
CA
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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