Provider Demographics
NPI:1275837346
Name:DAY, JACKIE JAKINO (CMT)
Entity Type:Individual
Prefix:MRS
First Name:JACKIE
Middle Name:JAKINO
Last Name:DAY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 DEER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6822
Mailing Address - Country:US
Mailing Address - Phone:970-252-1157
Mailing Address - Fax:
Practice Address - Street 1:105 S MESA AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3990
Practice Address - Country:US
Practice Address - Phone:970-252-1157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4255173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist