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KYOKO PROVENCIO
NPI 1659904514
Massage Therapist in Jacksonville, AR

Active since February 19, 2020
136 GREGORY PL, JACKSONVILLE, AR 72076(501) 412-4536 Get Directions Write a Review

NPPES record last updated: February 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kyoko Provencio NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYOKO PROVENCIO (NPI 1659904514) is an individual massage therapist in Jacksonville, Arkansas, licensed in Arkansas (7773) and active in the NPI registry since February 2020.

NPPES Registry Identity

NPI1659904514
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameKYOKO PROVENCIO
Location Address136 GREGORY PLJacksonville, AR 72076-3212
Mailing Address136 Gregory PlJacksonville, AR 72076-3212 · (501) 412-4536
Phone(501) 412-4536
Sole ProprietorYes
Enumeration DateFebruary 19, 2020
✔ NPI 1659904514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in AR · 7773
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
136 GREGORY PL, Jacksonville, AR 72076
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyoko Provencio's NPI number?

The NPI number for Kyoko Provencio is 1659904514. It was assigned to this individual provider in the NPPES registry on February 19, 2020.

Where is Kyoko Provencio located?

Kyoko Provencio practices at 136 Gregory Pl, Jacksonville, AR 72076. The listed phone number is (501) 412-4536.

What is Kyoko Provencio's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kyoko Provencio was last updated on February 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.