Individual
LANI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
807 S 3RD ST, LARAMIE, WY 82070-4419
(307) 742-6840
Mailing address
1659 N 4TH ST, APT 7, LARAMIE, WY 82072-3179
(307) 371-3142
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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