Individual
MIRANDA JACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7245 ROCKBRIDGE RD STE 600, LITHONIA, GA 30058-8615
(470) 415-0471
Mailing address
615 OAKVIEW TRL, STONE MOUNTAIN, GA 30087-6611
(470) 448-9452
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT015470
GA
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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