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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MARVALENE ROSLYNN JACK
NPI 1376454207
Massage Therapist in Conyers, GA

Active since September 17, 2026
PO BOX 82516, CONYERS, GA 30013(470) 227-5653 Get Directions Write a Review

NPPES record added: September 17, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Marvalene Roslynn Jack NPPES

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

MARVALENE ROSLYNN JACK (NPI 1376454207) is an individual massage therapist in Conyers, Georgia, licensed in Georgia (MT014691) and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1376454207
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameMARVALENE ROSLYNN JACK
Location AddressPO BOX 82516Conyers, GA 30013-9437
Mailing Address103 Salem Glen Way SeConyers, GA 30013-5323 · (470) 227-5653
Phone(470) 227-5653
Sole ProprietorYes
Enumeration DateSeptember 17, 2026
NPPES CertifiedSeptember 17, 2026
✔ NPI 1376454207 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 GA · MT014691
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.
PO BOX 82516, Conyers, GA 30013
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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 Marvalene Jack's NPI number?

The NPI number for Marvalene Jack is 1376454207. It was assigned to this individual provider in the NPPES registry on September 17, 2026.

Where is Marvalene Jack located?

Marvalene Jack practices at PO Box 82516, Conyers, GA 30013. The listed phone number is (470) 227-5653.

What is Marvalene Jack'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 Marvalene Jack was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.