Individual
KELLY R GOEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
107 S BROADWAY, STE 203 AND 204, RIVERTON, WY 82501
(307) 851-9979
Mailing address
503 N 2ND ST E, RIVERTON, WY 82501-3509
(307) 851-9979
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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