Individual
MS. JACQUELINE R. MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
322 S HARRISON ST, LEBANON, KY 40033-1132
(270) 321-0019
Mailing address
322 S HARRISON ST, LEBANON, KY 40033-1132
(270) 321-0019
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5049
KY
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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