Individual
MR. JOHNIE M. KELLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CACMT
Contact information
Practice address
895 SHERWOOD AVE STE 101, LOS ALTOS, CA 94022-1344
(650) 810-6582
Mailing address
171 HAMILTON AVE, MOUNTAIN VIEW, CA 94043-4204
(650) 810-6582
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1148
CA
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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