Individual
JESSICA G TOLLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMT
Contact information
Practice address
400 W CAPITOL AVE STE 2848, LITTLE ROCK, AR 72201-3415
(501) 650-9014
(501) 712-3075
Mailing address
21009 EDDIE RD, HENSLEY, AR 72065-8065
(501) 650-9014
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8115
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8115
STATE LICENSE
AR
Enumeration date
10/09/2017
Last updated
10/29/2020
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