Individual
LISA BOONE-KENNERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 CLARKSON DR, DANVILLE, VA 24540-2030
(202) 246-1349
Mailing address
414 CLARKSON DR, DANVILLE, VA 24540-2030
(202) 246-1349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019009022
VA
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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