Organization
JACKIE'S MYOMASSOLOGY HEALING AND WELLNESS LMT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKLYN JOAN-MARIE HANSEN (LICENSED MASSAGE THERAPIST)
(313) 633-4974
Entity
Organization
Contact information
Practice address
831 N PONTIAC TRL LOT 70, WALLED LAKE, MI 48390-3206
(313) 633-4974
Mailing address
831 N PONTIAC TRL LOT 70, WALLED LAKE, MI 48390-3206
(313) 633-4974
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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