Individual
KELLY ELAINE ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
203 COOPER AVE N STE 160, SAINT CLOUD, MN 56303-4418
(320) 309-7284
Mailing address
203 COOPER AVE N STE 160, SAINT CLOUD, MN 56303-4418
(320) 309-7284
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-1889495
—
MN
Enumeration date
11/08/2018
Last updated
11/08/2018
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