Individual
KIMBERLY SAGE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
448 E MAIN ST, SUITE A, BOZEMAN, MT 59715-4730
(406) 551-5731
Mailing address
PO BOX 552, PONY, MT 59747-0552
(406) 551-5731
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1357
MT
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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