Individual
EDWARD KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N KROHN PL, SIOUX FALLS, SD 57103-1815
(605) 331-0588
Mailing address
4001 W MARY JO PL APT 116, SIOUX FALLS, SD 57108-3514
(630) 666-5709
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT11949
SD
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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