Organization
JACKSON SPA LLC
Active
Other names
Jackson Massage and Day Spa, reke, cryosculpt
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLIE LEIGH WALLACE-WILDING MD (OWNER)
(901) 229-1744
Entity
Organization
Contact information
Practice address
31 WILEY PARKER RD STE H, JACKSON, TN 38305-5806
0
Mailing address
31 WILEY PARKER RD STE H, JACKSON, TN 38305-5806
0
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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