Individual
DIANE WALLACE KOSHLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.M.T
Contact information
Practice address
828 SAN PABLO AVE STE 104, ALBANY, CA 94706-1678
(925) 963-1405
Mailing address
828 SAN PABLO AVE STE 104, ALBANY, CA 94706-1678
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10396
CA
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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