Individual
GIANNYS MATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
, LMT
Contact information
Practice address
4010 DUPONT CIR STE 569, LOUISVILLE, KY 40207
(502) 276-1959
Mailing address
4010 DUPONT CIR STE 569, LOUISVILLE, KY 40207-4888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
108532
KY
225700000X
Massage Therapist
MA64622
FL
Other
Enumeration date
03/05/2013
Last updated
06/28/2018
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