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Kyoko Provencio
Massage Therapist in Jacksonville, Arkansas
NPI 1659904514

Kyoko Provencio is a Massage Therapist based in Jacksonville, AR. Kyoko Provencio practices in Jacksonville, AR. The NPI Number for Kyoko Provencio is 1659904514 and holds a License No. 7773 (Arkansas).

The current practice location address for Kyoko Provencio is 136 Gregory Pl, Jacksonville, AR and can be reached out via phone at 501-412-4536.

Location: 136 Gregory Pl, Jacksonville, AR, 72076-3212
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659904514
Provider Name
Kyoko Provencio
Credential
Provider Entity Type
Individual
Gender
Female
Address
136 Gregory Pl, Jacksonville, AR, 72076-3212
Phone Number
501-412-4536
Fax Number
Provider Enumeration Date
02/19/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
136 Gregory Pl
City
Jacksonville
State
Arkansas
Zip
72076-3212
Phone Number
501-412-4536
Fax Number
person
Provider Business Mailing Address Details
Address
136 Gregory Pl
City
Jacksonville
State
Arkansas
Zip
72076-3212
Phone Number
501-412-4536
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
7773 (Arkansas)
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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