NPI 1073383204

Alexander Jackson-Matu, LMT

Practitioner Massage Therapist Richmond, VA

Practice location

Address: 4906 Fitzhugh Ave STE 100, Richmond, VA 23230-3520
Phone: (614) 378-2722
Mailing address: 3600 W Broad St Unit 331, Richmond, VA 23230-4945

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 1261000096 (VA)

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Registry record

NPI: 1073383204
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jan 2024
Record last updated: 8 Jan 2024

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.