Individual
KEELY WILKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 AZTEC DR, EDEN PRAIRIE, MN 55347-1916
(612) 239-6728
Mailing address
8901 AZTEC DR, EDEN PRAIRIE, MN 55347-1916
(612) 239-6728
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
MASAGE
MN
Enumeration date
09/12/2018
Last updated
09/12/2018
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