Organization · Type 2 NPI

Jackson Spa LLC

Massage Therapist · Jackson, TN

NPI number 1932089091 Active

Practice location

31 Wiley Parker Rd Ste H
Jackson, TN 38305-5806

Specialties and licenses

Taxonomy	Code	License
Massage Therapist Primary	225700000X	None listed

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.

3 other providers at this address

NPI record

NPI: 1932089091
Entity type: Organization (Type 2)
Issued: Sep 8, 2025
Last updated: Sep 8, 2025
Status: Active

Other names

Jackson Massage and Day Spa · doing business as
Cryosculpt · doing business as
Reke · other name

Authorized official

Dr. Kellie Leigh Wallace-Wilding, MD
Owner
(901) 229-1744

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1932089091

Jackson Spa LLC's National Provider Identifier is 1932089091, issued on Sep 8, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Jackson, TN. The record was last updated on Sep 8, 2025.