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Individual

MS. KRISTI S ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
15811 W DODGE RD STE 152, OMAHA, NE 68118-4013
(402) 578-1023
Mailing address
15811 W DODGE RD STE 152, OMAHA, NE 68118-4013
(402) 578-1023

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1452
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1452
MASSAGE THERAPY LICENSE
NE
Enumeration date
10/18/2017
Last updated
01/03/2024
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