Individual
HAEKYONG CECILIA VISNESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8307 MILWAUKEE ST, JOINT BASE LEWIS MCCHORD, WA 98433-1322
(254) 577-2365
Mailing address
8307 MILWAUKEE ST, JOINT BASE LEWIS MCCHORD, WA 98433-1322
(254) 577-2365
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60711068
WA
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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