Individual
KELLI MIRR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4921 SHERIDAN ST, SUITE 6, HOLLYWOOD, FL 33021-2823
(954) 924-8878
Mailing address
4921 SHERIDAN ST, SUITE 6, HOLLYWOOD, FL 33021-2823
(954) 924-8878
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
28886
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 28886
LICENSE MASSAGE THERAPIST
FL
Enumeration date
12/21/2009
Last updated
12/21/2009
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