Individual
MR. CHRISTOPHER AINSLEY NALLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
124 WREN WAY, NEWARK, DE 19711-8330
(302) 525-6808
Mailing address
124 WREN WAY, NEWARK, DE 19711-8330
(302) 525-6808
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-0004504
DE
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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