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1003415464
KIM B JACKSON
GLEN COVE, NY
NPI
1003415464
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: NY 028858)
Enumeration Date
2020-10-18
Last Update Date
2020-10-18
Business Address
KIM B JACKSON
29 GLEN COVE AVE STE 212
GLEN COVE, NY 11542-2831
Phone number: 516-384-7670
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Mailing Address
KIM B JACKSON
1360 C ST
ELMONT, NY 11003-3816
Phone number: 516-384-7670
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