Individual
KELLY LYNN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
48 CEDAR RD, KINGS PARK, NY 11754-3307
(631) 487-2149
Mailing address
48 CEDAR ROAD, KINGS PARK, NY 11754
(631) 487-2149
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
27 020636
NY
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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