Individual
MRS. LISA ANN REAVLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
27215 UNIT B HWY 189, BLUE JAY, CA 92317
(909) 767-5686
Mailing address
PO BOX 152, CEDAR GLEN, CA 92321-0152
(909) 767-5686
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
73153
CA
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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