Individual
KELLIE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMMP
Contact information
Practice address
29 BALA AVE, STE 122, BALA CYNWYD, PA 19004-3206
(267) 317-8985
Mailing address
5208 EUCLID ST, PHILADELPHIA, PA 19131
(610) 809-9009
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG009784
PA
Other
Enumeration date
09/24/2018
Last updated
10/10/2024
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