Individual
MARIESHA D WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1500 LEESTOWN RD STE 338, BAKHAUS BLDG, LEXINGTON, KY 40511-2047
(859) 317-8295
Mailing address
618 NAKOMI DR, LEXINGTON, KY 40503-2104
(304) 634-5501
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY2009
KY
Other
Enumeration date
11/22/2014
Last updated
11/22/2014
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