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Individual

MS. JACQUELINE MARIE EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T

Contact information

Practice address
3604 LAREDO DR, A, LEXINGTON, KY 40517-2173
(859) 536-2038
Mailing address
3604 LAREDO DR, A, LEXINGTON, KY 40517-2173
(859) 536-2038

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4033
KY

Other

Enumeration date
04/20/2011
Last updated
11/19/2012
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