Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Marvalene Roslynn Jack

Individual provider Massage Therapist · NPI 1376454207

Marvalene Roslynn Jack is a Massage Therapist in Conyers, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2026
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 82516
Conyers, GA 30013-9437
Phone: (470) 227-5653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT014691 (GA)

Record details

NPI number1376454207
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 17, 2026
Last updated in NPPESSeptember 17, 2026
Certification dateSeptember 17, 2026

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