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Individual

PATRICIA KIRIAZIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
8380 CENTER DR STE E, LA MESA, CA 91942-2952
(619) 466-6077
Mailing address
9226 LAKE VALLEY RD, EL CAJON, CA 92021-1976
(619) 375-7871

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
78871
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78871
CA
01
87726
MEDICARE
WA
Enumeration date
08/18/2021
Last updated
08/18/2021
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