Individual
MS. KATHLEEN MARIE WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10000 NW 53RD CT, CORAL SPRINGS, FL 33076-2422
(954) 345-8754
(954) 345-8754
Mailing address
10000 NW 53 COURT, CORAL SPRINGS, FL 33076
(954) 345-8754
(954) 345-8754
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0019304
FL
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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