Kathleen Jackman, L.M.T.

NPI #1194138297 in El Prado, New Mexico

Provider Information

NPI Number: 1194138297
Entity Type: Individual
Name: Kathleen Jackman, L.M.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: L.M.T.
Enumeration Date: Jun 5, 2014
Last Updated: Jun 5, 2014

Practice Location

Address: 98 HIGHWAY 150
Address 2: SUITE 11
City: El Prado
State: New Mexico
ZIP Code: 87529-7461
Phone: (575) 770-2001

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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