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JEREMIAH KENDALE MACK
NPI 1043807324
Massage Therapist in Phoenix, AZ

Active since December 21, 2020
16410 S 12TH ST APT 213, PHOENIX, AZ 85048(480) 765-0367 Get Directions Write a Review

NPPES record last updated: December 21, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jeremiah Kendale Mack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMIAH KENDALE MACK (NPI 1043807324) is an individual massage therapist in Phoenix, Arizona, licensed in Arizona (MT-25692) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1043807324
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameJEREMIAH KENDALE MACK
Location Address16410 S 12TH ST APT 213Phoenix, AZ 85048-4007
Mailing Address16410 S 12th St Apt 213Phoenix, AZ 85048-4007
Phone(480) 765-0367
Sole ProprietorYes
Enumeration DateDecember 21, 2020
NPPES CertifiedDecember 21, 2020
✔ NPI 1043807324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in AZ · MT-25692
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
16410 S 12TH ST APT 213, Phoenix, AZ 85048
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremiah Mack's NPI number?

The NPI number for Jeremiah Mack is 1043807324. It was assigned to this individual provider in the NPPES registry on December 21, 2020.

Where is Jeremiah Mack located?

Jeremiah Mack practices at 16410 S 12th St Apt 213, Phoenix, AZ 85048. The listed phone number is (480) 765-0367.

What is Jeremiah Mack's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Jeremiah Mack was last updated on December 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.