MEDICARE: JESSIE COLSTON LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA99838	FL

General Provider Information

NPI Number	:	1659203222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE COLSTON LMT

Provider Business Mailing Address
First Line	:	515 WRIGHT CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-9644
Country	:	US
Telephone Number	:	561-701-4789
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 24TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-3351
Country	:	US
Telephone Number	:	561-701-4789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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Directions to “ JESSIE COLSTON LMT” Practice Location

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