Organization
FIRESIDE MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY ANN SKLODOWSKI LMT (LICENCED MASSAGE THERAPIST)
(814) 932-9669
Entity
Organization
Contact information
Practice address
110 KEYSTONE AVE, CRESSON, PA 16630-1213
(814) 932-9669
Mailing address
110 KEYSTONE AVE, CRESSON, PA 16630-1213
(814) 932-9669
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MSG003985
PA
Other
Enumeration date
04/28/2015
Last updated
04/28/2015
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