Individual
KELSEY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
16500 JOY RD # 258, DETROIT, MI 48228-0632
(248) 417-5352
(888) 793-5313
Mailing address
16500 JOY RD # 258, DETROIT, MI 48228-0632
(248) 417-5352
(888) 793-5313
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501007544
MI
Other
Enumeration date
02/01/2016
Last updated
03/02/2025
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