Individual
KIMBERLY RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9175 CYPRESS WATERS BLVD APT 102, COPPELL, TX 75019-5068
(404) 427-8793
Mailing address
9175 CYPRESS WATERS BLVD APT 102, COPPELL, TX 75019-5068
(404) 427-8793
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT010418
GA
225700000X
Massage Therapist
Primary
MT126228
TX
Other
Enumeration date
01/05/2016
Last updated
01/06/2017
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