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Individual

MICHELE KENNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
595 ROUTE 25A, MILLER PLACE, NY 11764-2646
(631) 987-8822
Mailing address
29 VINE RD, ROCKY POINT, NY 11778-8922
(631) 987-8822

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
006622
NY

Other

Enumeration date
06/07/2020
Last updated
06/07/2020
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