Individual
KELLY LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4752 BUNKER RD, MASON, MI 48854-9781
(517) 285-2415
Mailing address
4752 BUNKER RD, MASON, MI 48854-9781
(517) 285-2415
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501015844
MI
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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