Healthcare Provider Details

I. General information

NPI: 1285576991
Provider Name (Legal Business Name): RELAX & RESTORE STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 MEDGAR EVERS BLVD STE 15
JACKSON MS
39213-5205
US

IV. Provider business mailing address

768 CHERRY STONE DR
CLINTON MS
39056-2015
US

V. Phone/Fax

Practice location:
  • Phone: 769-233-5948
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JASMINE GREEN
Title or Position: OWNER
Credential:
Phone: 601-397-9036