Individual
KIM LEE FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 MAIN ST, HYANNIS, MA 02601-5100
(508) 694-6598
Mailing address
PO BOX 1083, OSTERVILLE, MA 02655-5083
(508) 790-0606
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
777
MA
Other
Enumeration date
05/21/2012
Last updated
06/14/2013
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