Individual
KELLY LYNNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2800 NORGARD CIR, CARLISLE, IA 50047-8001
(515) 689-3858
Mailing address
16425 FULTON ST, INDIANOLA, IA 50125-9055
(515) 689-3858
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
005983
IA
Other
Enumeration date
01/25/2025
Last updated
01/25/2025
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