Individual
MR. MARK JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
12795 SAN JOSE BLVD, STE 9, JACKSONVILLE, FL 32223-2669
(904) 415-6744
Mailing address
12795 SAN JOSE BLVD, STE 9, JACKSONVILLE, FL 32223-2669
(904) 415-6744
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
54995
FL
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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