Organization
J.KELLEY SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JILL MARIE KELLEY COSMETOLIGIST (OWNER)
(207) 846-9696
Entity
Organization
Contact information
Practice address
81 BRIDGE ST, YARMOUTH, ME 04096-6744
(207) 846-9696
Mailing address
81 BRIDGE ST, YARMOUTH, ME 04096-6744
(207) 846-9696
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CO13731
ME
Other
Enumeration date
02/10/2009
Last updated
02/10/2009
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