Individual
JASON JESSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 HUEY P LONG AVE APT 111, GRETNA, LA 70053-6956
(504) 518-3135
Mailing address
PO BOX 1252, MARRERO, LA 70073-1252
(504) 518-3135
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA9224
LA
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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