Individual
KELLY JO EMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
51 PINE ST, UNIT G, SANDPOINT, ID 83864
(208) 502-0728
Mailing address
639 FOREST KNOLLS DR, SANDPOINT, ID 83864-5283
(360) 909-3331
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS
ID
225700000X
Massage Therapist
MAS
—
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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