Individual
KAYLEE AVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, GTP, CPT
Contact information
Practice address
3070 S WALNUT ST, BLOOMINGTON, IN 47401-7333
(812) 727-4120
Mailing address
12580 S RICHARD CT, GALVESTON, IN 46932-8626
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22007230
IN
Other
Enumeration date
10/02/2021
Last updated
10/02/2021
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