NPI 1598368557

Jacob Johnson, MT

Practitioner Massage Therapist Avon, IN

Practice location

Address: 6319 E US Highway Suite 9, Avon, IN 46123-4612
Phone: (317) 707-7151
Mailing address: 6555 E County Road 700 N, Brownsburg, IN 46112-9024

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MT22007253 (IN)

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Registry record

NPI: 1598368557
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Nov 2020
Record last updated: 20 Nov 2020

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.