NPI 1073890828

Stephanie Jackson, CMT

Practitioner Massage Therapist Englewood, CO

Practice location

Address: 3172 S Gilpin St, Englewood, CO 80113-3023
Phone: (303) 476-0294

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 10659 (CO)

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Registry record

NPI: 1073890828
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Nov 2011
Record last updated: 8 Nov 2011

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.