Individual
MATTHEW HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4270 ROBINSON ST, JACKSON, MS 39209-6517
(601) 383-4747
Mailing address
1917 WINGFIELD CIR, JACKSON, MS 39209-7129
(601) 383-4747
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1981
MS
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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