Individual
JACLYN JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 BROOKS ST W, HICKSVILLE, NY 11801-5543
(151) 445-5613
Mailing address
28 BROOKS ST W, HICKSVILLE, NY 11801-5543
(151) 445-5613
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026340
NY
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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