Individual
STACY E KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
312 THALIA STATION CT, VIRGINIA BEACH, VA 23452-1752
(757) 559-4544
Mailing address
312 THALIA STATION CT, VIRGINIA BEACH, VA 23452-1752
(757) 559-4544
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019007831
VA
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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