Individual
ELLEN KATHLEEN BUDNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
505 US HIGHWAY 80 W, POOLER, GA 31322-2190
(914) 450-4044
Mailing address
18 LONGLEAF CIR, POOLER, GA 31322-9339
(912) 656-5825
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005177
GA
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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