Jackpot

NPI #1386810034 in Casco, Maine

Provider Information

NPI Number: 1386810034
Entity Type: Organization
Organization Name: Jackpot
Primary Specialty: Massage Therapist
Enumeration Date: May 2, 2008
Last Updated: May 2, 2008

Practice Location

Address: 5 S CASCO VILLAGE RD
City: Casco
State: Maine
ZIP Code: 04015-4246
Phone: (207) 655-2520

Authorized Official

Name: MRS. LORI ANN SHAW, L.M.T.
Title: COORDINATOR
Phone: (207) 655-2520

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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