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Kevin Wallace
Massage Therapist in Modesto, California
NPI 1518391135

Kevin Wallace is a Massage Therapist based in Modesto, CA. Kevin Wallace practices in Modesto, CA. The NPI Number for Kevin Wallace is 1518391135 and holds a License No. 48846 (California).

The current practice location address for Kevin Wallace is 817 Coffee Rd Ste D, Modesto, CA and can be reached out via phone at 209-527-6100. You can also correspond with Kevin Wallace through the mailing address at 817 COFFEE RD STE D, MODESTO, CA - 95355-4241 (mailing address contact number: 209-527-6100).

Location: 817 Coffee Rd Ste D, Modesto, CA, 95355-4241
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518391135
Provider Name
Kevin Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
817 Coffee Rd Ste D, Modesto, CA, 95355-4241
Phone Number
209-527-6100
Fax Number
Provider Enumeration Date
08/30/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
817 Coffee Rd Ste D
City
Modesto
State
California
Zip
95355-4241
Phone Number
209-527-6100
Fax Number
person
Provider Business Mailing Address Details
Address
817 Coffee Rd Ste D
City
Modesto
State
California
Zip
95355-4241
Phone Number
209-527-6100
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
48846 (California)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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