Individual provider · Type 1 NPI

Marvalene Roslynn Jack

Massage Therapist · Conyers, GA

NPI number 1376454207 Active

Practice location

PO Box 82516
Conyers, GA 30013-9437

Call (470) 227-5653 Map

Mailing address

103 Salem Glen Way SE
Conyers, GA 30013-5323

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMT014691 (GA)

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 1376454207

Marvalene Roslynn Jack's National Provider Identifier is 1376454207, issued on Sep 17, 2026. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Conyers, GA. The record was last updated on Sep 17, 2026.