MISS Nakita R Jack, LMT

NPI #1033865340 in Hayden, Idaho

Provider Information

NPI Number: 1033865340
Entity Type: Individual
Name: MISS Nakita R Jack, LMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Feb 24, 2022
Last Updated: Feb 24, 2022

Practice Location

Address: 9751 N GOVERNMENT WAY STE 4
City: Hayden
State: Idaho
ZIP Code: 83835-9645
Phone: (208) 696-1330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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