Individual
KELSEY O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
960 S BROADWAY AVE, SUITE 200, BOISE, ID 83706-3600
(208) 433-9211
(208) 433-9241
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1598
ID
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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