Individual
ANTONIO CLYBURN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
6985 COAL CREEK PKWY SE, NEWCASTLE, WA 98059-3136
(425) 378-0500
(425) 378-8168
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60698755
WA
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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