Individual
CHRISTINA R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
929 N SPRING GARDEN AVE, ST. 100, DELAND, FL 32720-0900
(386) 734-2592
(386) 734-1773
Mailing address
929 N SPRING GARDEN AVE, ST. 100, DELAND, FL 32720-0900
(386) 734-2592
(386) 734-1773
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA36547
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2264
BCBS OF FLORIDA
FL
Enumeration date
02/27/2007
Last updated
07/08/2007
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