Individual
MISS KELLY MARIE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.B.T
Contact information
Practice address
25 QUAIL HOLLOW RD, FAIRVIEW, NC 28730-8505
(828) 777-5083
Mailing address
2 FAIRVIEW HILLS DR, FAIRVIEW, NC 28730-9777
(828) 777-5083
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5397
NC
Other
Enumeration date
01/19/2010
Last updated
01/19/2010
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