Individual
MISS LYDIA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3975 STATE HIGHWAY 6 S, SUITE 700, COLLEGE STATION, TX 77845
(979) 696-2000
Mailing address
4345 CARTER CREEK DR., 9, BRYAN, TX 77802
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT114234
TX
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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