Individual
MS. KELLY LYNN PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
215 S MAIN ST, NEWARK, NY 14513-1460
(315) 573-3549
Mailing address
118 PINE RIDGE DR, NEWARK, NY 14513-9184
(315) 576-6953
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023112-1
NY
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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