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Individual
MRS. OLIVIA M. KELLAR
Active
Individual
MRS. OLIVIA M. KELLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, MACOM, LMT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
459
TN
225700000X
Massage Therapist
17162
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17162
OBMT LICENSE OREGON LMT
OR
01
—
459
LICENSED ACUPUNCTURIST L.AC., M.AC.O.M.
TN
Enumeration date
09/17/2013
Last updated
03/04/2022
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