Healthcare Provider Details

I. General information

NPI: 1235908443
Provider Name (Legal Business Name): ALLYSON KRISTINE JEUNELOT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 KENBROOK DR STE 4
VANDALIA OH
45377-2400
US

IV. Provider business mailing address

7417 HARSHMANVILLE RD
HUBER HEIGHTS OH
45424-3012
US

V. Phone/Fax

Practice location:
  • Phone: 937-271-8332
  • Fax:
Mailing address:
  • Phone: 937-271-8332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.023831
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: