Individual
KATRINA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5771
(716) 631-1516
Mailing address
400 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5771
(716) 631-1516
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032935
NY
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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