Individual
KATHY JO KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
165 STATE ST, BREWER, ME 04412-1536
(207) 992-8175
Mailing address
76 MASONIC RD, DIXMONT, ME 04932-3543
(207) 992-8175
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT2654
ME
Other
Enumeration date
12/06/2006
Last updated
03/26/2008
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