NPI 1033865340

Nakita R Jack, LMT

Practitioner Massage Therapist Hayden, ID

Practice location

Address: 9751 N Government Way STE 4, Hayden, ID 83835-9645
Phone: (208) 696-1330
Fax: (208) 684-7834

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MAS3883 (ID)

Other Massage Therapist providers in Idaho →

Registry record

NPI: 1033865340
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Feb 2022
Record last updated: 24 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.