Individual
JON DAVID HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
106 N KEECHI ST, FAIRFIELD, TX 75840-4226
(903) 391-7643
Mailing address
210 W DALLAS ST, PALESTINE, TX 75801-3520
(903) 391-7643
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT044078
TX
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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