Individual
YELENA Y GURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1755 17TH AVE E, SHAKOPEE, MN 55379-3372
(952) 445-5250
Mailing address
1755 17TH AVE E, SHAKOPEE, MN 55379-3372
(952) 445-5250
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234
MASSAGE THERAPIST
—
Enumeration date
10/27/2021
Last updated
10/27/2021
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