Latasha M. Jackson LMBT
Massage Therapist in Concord, NC(View on Map)
Full Name
Latasha Monique Jackson LMBT
NPI Number
1013585447
NPI Type
Individual Provider
Gender
Female
Enumeration Date
06/13/2021
Specialties
(Taxonomies)Licenses
State
North Carolina
License Number
11988
Contact
Information
Purpose
Mailing
Location
Address
1270 PINE RIDGE RD
78 CHURCH ST NE
City
China Grove
Concord
State
NC
NC
Postal Code
28023-8601
28025-4757
Country
US
US
Telephone Number
(980) 219-1809
(980) 219-1809
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/13/2021
Provider Address
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