Individual
KEVIN GLEAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
312 NATOMA ST STE 110, FOLSOM, CA 95630-2692
(916) 837-6582
Mailing address
1725 ATWELL ST, ROSEVILLE, CA 95747-6471
(916) 837-6582
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
67156
CA
Other
Enumeration date
04/07/2018
Last updated
04/07/2018
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