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1013585447
LATASHA MONIQUE JACKSON
CONCORD, NC
NPI
1013585447
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: NC 11988)
Enumeration Date
2021-06-13
Last Update Date
2021-06-13
Business Address
LATASHA MONIQUE JACKSON LMBT
78 CHURCH ST NE
CONCORD, NC 28025-4757
Phone number: 980-219-1809
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Mailing Address
LATASHA MONIQUE JACKSON LMBT
1270 PINE RIDGE RD
CHINA GROVE, NC 28023-8601
Phone number: 980-219-1809
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