Individual
KIMBERLY LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1122 CORPORATE WAY, SACRAMENTO, CA 95831-6124
(916) 395-5804
Mailing address
1122 CORPORATE WAY STE 300, SACRAMENTO, CA 95831-6125
(916) 395-5804
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
75506
CA
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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