Individual
CHEYELLE COUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7686 W RIDGE RD, FAIRVIEW, PA 16415-1074
(814) 440-3759
Mailing address
426 HILLCREST DR, GIRARD, PA 16417-1308
(814) 440-3759
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG006884
PA
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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