KYOKO PROVENCIO

Massage Therapist

Active Individual
NPI: 1659904514

Practice Address

136 GREGORY PL
Jacksonville, AR 72076

Phone: (501) 412-4536

Specialties

Specialty Code Primary License
Massage Therapist 225700000X Yes 7773 (AR)

Frequently Asked Questions

NPI 1659904514 is the National Provider Identifier for KYOKO PROVENCIO, a Massage Therapist provider located in Jacksonville, AR. This NPI was enumerated on February 19, 2020.
KYOKO PROVENCIO practices at 136 GREGORY PL, Jacksonville, AR 72076.

Quick Facts

NPI
1659904514
Type
Individual
Enumerated
Feb 19, 2020
Last Updated
Feb 19, 2020

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