Organization
KEEP GLOWING MEDICAL SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J ELLIS DO (OWNER)
(848) 217-2660
Entity
Organization
Contact information
Practice address
4057 ASBURY AVE STE 21, TINTON FALLS, NJ 07753-7700
(848) 217-2662
Mailing address
4057 ASBURY AVE STE 21, TINTON FALLS, NJ 07753-7700
(848) 217-2662
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
01/17/2023
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