Individual
DAVONNA WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
105 E ST STE 5, RICHMOND, KY 40475-1607
(606) 791-8741
Mailing address
105 E ST UNIT B, RICHMOND, KY 40475-1607
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
266776
KY
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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