Kyoko Provencio, | |
136 Gregory Pl, Jacksonville, AR 72076-3212 | |
(501) 412-4536 | |
Not Available |
Full Name | Kyoko Provencio |
---|---|
Gender | Female |
Speciality | Massage Therapist |
Location | 136 Gregory Pl, Jacksonville, Arkansas |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659904514 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225700000X | Massage Therapist | 7773 (Arkansas) | Primary |
Mailing Address | Practice Location Address |
---|---|
Kyoko Provencio, 136 Gregory Pl, Jacksonville, AR 72076-3212 Ph: (501) 412-4536 | Kyoko Provencio, 136 Gregory Pl, Jacksonville, AR 72076-3212 Ph: (501) 412-4536 |
Melissa Sue Cohen, MMT, LE Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1310 John Harden Dr Ste B, Jacksonville, AR 72076 Phone: 501-515-4324 | |
Coleman Alexander, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1108 W Main St Ste B, Jacksonville, AR 72076 Phone: 501-672-4188 |