Individual provider · Type 1 NPI

Kim B. Jackson

Massage Therapist · Glen Cove, NY

NPI number 1003415464 Active

Practice location

29 Glen Cove Ave Ste 212
Glen Cove, NY 11542-2831

Call (516) 384-7670 Map

Mailing address

1360 C St
Elmont, NY 11003-3816

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X028858 (NY)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1003415464

Kim B. Jackson's National Provider Identifier is 1003415464, issued on Oct 18, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Glen Cove, NY. The record was last updated on Oct 18, 2020.