| Kyoko Provencio, | |
|
136 Gregory Pl, Jacksonville, AR 72076-3212 | |
| (501) 412-4536 | |
| Not Available |
| Full Name | Kyoko Provencio |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 136 Gregory Pl, Jacksonville, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659904514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 7773 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kyoko Provencio, 136 Gregory Pl, Jacksonville, AR 72076-3212 Ph: (501) 412-4536 | Kyoko Provencio, 136 Gregory Pl, Jacksonville, AR 72076-3212 Ph: (501) 412-4536 |
Body In Balance Massage Therapy & Esthetics, Llc Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1310 John Harden Dr, Jacksonville, AR 72076 Phone: 501-515-4324 | |
Melissa Sue Cohen, MMT, LE Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1310 John Harden Dr Ste B, Jacksonville, AR 72076 Phone: 501-515-4324 | |
Coleman Alexander, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1108 W Main St Ste B, Jacksonville, AR 72076 Phone: 501-672-4188 |