Individual
JACQUELINE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3464 AVE A, COUNCIL BLUFFS, IA 51501-1817
(712) 256-6877
Mailing address
3464 AVE A, COUNCIL BLUFFS, IA 51501-1817
(712) 256-6877
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3632
NE
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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