Kim B Jackson
Massage Therapist
29 Glen Cove Ave Ste 212
Glen Cove
, New York 11542-2831
Kim B Jackson
Massage Therapist
29 Glen Cove Ave Ste 212
Glen Cove
, New York 11542-2831
(516) 384-7670
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Kim B Jackson
- 1360 C St
- Elmont, NY
- Zip : 11003-3816
- Phone : (516) 384-7670
Second Address
- Kim B Jackson
- 29 Glen Cove Ave Ste 212
- Glen Cove, NY
- Zip : 11542-2831
- Phone : (516) 384-7670
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 028858 | NY |
National Provider Identifier
| NPI | 1003415464 |
|---|---|
| Provider Name | Kim B Jackson |
| First Address | Elmont, NY 11003-3816 |
| Second Address | Glen Cove, NY 11542-2831 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2020 |
| Last Update Date | 18/10/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.