Individual
MS. JESSICA B WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
4955 AMITY LN, IRON STATION, NC 28080-9755
(803) 207-9902
Mailing address
4955 AMITY LN, IRON STATION, NC 28080-9755
(803) 207-9902
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13274
NC
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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