Individual
MS. MARYLISA AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 COLLEGE AVE, SUITE A, SOUTH MILWAUKEE, WI 53172
(414) 762-8441
Mailing address
1334 MANITOBA AVE, SOUTH MILWAUKEE, WI 53172
(414) 241-9174
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11545-146
WI
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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