Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremiah Kendale Mack

Individual provider Massage Therapist · NPI 1043807324

Jeremiah Kendale Mack is a Massage Therapist in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

16410 S 12th St Apt 213
Phoenix, AZ 85048-4007
Phone: (480) 765-0367
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT-25692 (AZ)

Record details

NPI number1043807324
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 21, 2020
Last updated in NPPESDecember 21, 2020
Certification dateDecember 21, 2020

Other providers in Phoenix