Individual
IESHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2871 GENESEE ST, BUFFALO, NY 14225-3141
(716) 939-7222
Mailing address
224 BLAINE AVE, BUFFALO, NY 14208-1018
(716) 939-2222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032732
NY
Other
Enumeration date
01/04/2023
Last updated
01/21/2025
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