Individual
TIFFANY C. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
140 S MAIN ST #3, PLEASANT GROVE, UT 84062-3560
(801) 899-3904
Mailing address
904 S MAIN ST, PLEASANT GROVE, UT 84062-3560
(801) 687-3957
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6077621-4701
UT
Other
Enumeration date
07/12/2010
Last updated
08/03/2022
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