Organization
FOCUS CLINICAL MASSAGE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW BENJAMIN KELLY LMT (MEMBER; LICENSED MASSAGE THERAPIST)
(616) 635-1267
Entity
Organization
Contact information
Practice address
535 GREENWOOD AVE SE, EAST GRAND RAPIDS, MI 49506-2901
(616) 635-1267
(616) 635-1267
Mailing address
550 GREENWOOD AVE SE, EAST GRAND RAPIDS, MI 49506-2911
(616) 635-1267
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501001100
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871961227
—
MI
Enumeration date
01/05/2018
Last updated
01/05/2018
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