Individual
KELLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
519 J AVE, NEVADA, IA 50201-1841
(515) 290-6349
Mailing address
905 G AVE, NEVADA, IA 50201-2345
(515) 290-6349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
119329
IA
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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