Individual
KIMBERLY TELLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5555 N LAMAR BLVD, STE 121C, AUSTIN, TX 78751-1073
(512) 662-6588
Mailing address
5555 N LAMAR BLVD, STE 121C, AUSTIN, TX 78751-1073
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT105473
TX
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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