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Individual

MS. IRENE KOUFALIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
5620 EAST TEXAS ROAD, EAST TEXAS, PA 18046
(610) 530-2203
(610) 398-8828
Mailing address
PO BOX 367, EAST TEXAS, PA 18046
(610) 530-2003
(610) 398-8828

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG004776
PA

Other

Enumeration date
05/04/2018
Last updated
05/04/2018
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