NPI
Jackson Spa Llc
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2025-09-08
- Last updated
- 2025-09-08
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 31 Wiley Parker Rd Ste H
- City
- Jackson TN
- Postal code
- 38305-5806
Organization contact
- Name
- KELLIE WALLACE-WILDING
- Title
- Owner
- Phone
- 9012291744
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Jackson, TN. 3,209 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.
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