Jacqueline Coleman, MASSAGE THERAPY

Individual provider Active NPI Massage Therapist · Batesburg, SC

NPI 1356583249 · NPPES record last updated Mar 24, 2009

Key facts

NPI
1356583249
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
5600 (SC)
Practice address
129 Holder Rd
Batesburg, SC 29006-9425
Phone
(803) 609-5095
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5600SCMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 5600 SC Yes

Addresses

Primary practice location

129 Holder Rd
Batesburg, SC 29006-9425

Mailing address

129 Holder Rd
Batesburg, SC 29006-9425
Phone (803) 609-5095

Other providers in Batesburg, SC

All providers in Batesburg, SC · Massage Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.