KEVIN WALLACE

MODESTO, CA
NPI1518391135
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225700000X Massage Therapist
(Licence: CA  48846)
Enumeration Date2013-08-30
Last Update Date2013-08-30
Business Address
-- KEVIN WALLACE
817 COFFEE RD STE D
MODESTO, CA 95355-4241
Phone number: 209-527-6100
Mailing Address
-- KEVIN WALLACE
817 COFFEE RD STE D
MODESTO, CA 95355-4241
Phone number: 209-527-6100