Individual
REGINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6920 AIRPORT BLVD STE 111, MOBILE, AL 36608-3783
(251) 607-8531
Mailing address
5714 RAMADA DR S, MOBILE, AL 36693-3528
(251) 680-6230
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3422
AL
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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