Individual
KYLE G. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
5780 RAMSEY ST STE 105, FAYETTEVILLE, NC 28311-1414
(910) 488-3322
Mailing address
3739 COLORADO DR, HOPE MILLS, NC 28348-2105
(910) 568-2058
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
225700000X
Massage Therapist
Primary
19362
NC
Other
Enumeration date
07/31/2024
Last updated
02/07/2026
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