Individual
MRS. JESSICA MINK HAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2420 BEMISS RD STE B, VALDOSTA, GA 31602-4809
(229) 293-9511
(229) 293-9141
Mailing address
2231 BEMISS RD STE B, VALDOSTA, GA 31602-4812
(229) 241-9300
(229) 241-9301
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT 00892
—
Other
Enumeration date
07/24/2009
Last updated
10/04/2011
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