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Individual

JOSEPH JAMES LEWELLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NC LMBT#12980

Contact information

Practice address
4 ENTERPRISE AVE NE, ISANTI, MN 55040-6813
(763) 552-6161
Mailing address
7727 269TH AVE NE, STACY, MN 55079-3178
(828) 767-2169

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12980
NC

Other

Enumeration date
06/27/2023
Last updated
06/27/2023
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