Individual
KELLI RAE BACKHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 W 6TH ST APT 323, AUSTIN, TX 78703-5011
(512) 608-7647
Mailing address
1616 W 6TH ST APT 323, AUSTIN, TX 78703-5011
(512) 608-7647
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT121927
TX
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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