Individual
MR. KYLE MICHAEL MATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6001 SHELLMOUND ST STE 115, EMERYVILLE, CA 94608-1924
(510) 653-5200
Mailing address
313 S NAVARRA DR, SCOTTS VALLEY, CA 95066-3647
(831) 818-7476
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15731
CA
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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