Individual
YVONNE PEREZ KETTERING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
8701 SHOAL CREEK BLVD, SUITE 302, AUSTIN, TX 78757-6864
(512) 801-2453
(512) 420-8573
Mailing address
8701 SHOAL CREEK BLVD, SUITE 302, AUSTIN, TX 78757-6864
(512) 801-2453
(512) 420-8573
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
TXAC00847
TX
172M00000X
Mechanotherapist
MT107098
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUE CROSS BLUE SHIELD
TX
05
—
0944746-02
—
TX
Enumeration date
01/28/2011
Last updated
07/01/2013
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