National Provider Identifier

Corrine R Jackson, LMT

Corrine R Jackson, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Buffalo, NY and a listed phone number of (716) 235-1338.

NPI 1952187882Buffalo, NYMassage Therapist

Profile Overview

NPI
1952187882
Provider Type
Individual
Primary Specialty
Massage Therapist
Enumeration Date
September 06, 2023
Last Updated
May 08, 2025

Practice Location

  • 40 N Forest RD
  • Buffalo, NY 14221-5230

Phone: (716) 235-1338

Mailing Address

  • 23 New Southgate RD Lowr
  • Buffalo, NY 14215-1809

Specialties

  • Massage Therapist (225700000X)
Full Record
NPI
1952187882
Entity Type
Individual
Last Name
Jackson
First Name
Corrine
Middle Name
R
Credential
LMT
Mailing Street Address
23 New Southgate RD Lowr
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14215-1809
Mailing Country
US
Mailing Phone
(716) 310-4070
Practice Street Address
40 N Forest RD
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14221-5230
Practice Country
US
Practice Phone
(716) 235-1338
Enumeration Date
September 06, 2023
Last Updated
May 08, 2025
Sex
Female
Sole Proprietor
Yes
Certification Date
May 08, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Massage Therapist (225700000X)