Individual
KELLY MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 BROADWAY ST STE C, ROCK SPRINGS, WY 82901-6380
(307) 382-8661
Mailing address
3448 DOVER AVE, ROCK SPRINGS, WY 82901-5776
(307) 389-8953
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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