Provider Demographics
NPI:1679284186
Name:BEST, JASMINE NICOLE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:NICOLE
Last Name:BEST
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 MR JOE WHITE AVE UNIT 119
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5660
Mailing Address - Country:US
Mailing Address - Phone:843-254-5790
Mailing Address - Fax:
Practice Address - Street 1:6514 DICK POND RD # 249
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-9277
Practice Address - Country:US
Practice Address - Phone:843-254-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12875225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist