Individual
MR. MICHAEL H KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
76 BOSSE LN, WEST SENECA, NY 14224-1624
(716) 868-9097
Mailing address
76 BOSSE LN, WEST SENECA, NY 14224-1624
(716) 868-9097
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018507-1
NY
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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