Individual
KELLY LYNN HILEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
511 W RUBY ST, CONWAY, MO 65632-9623
(417) 589-4400
Mailing address
511 W RUBY ST, CONWAY, MO 65632-9623
(417) 589-4400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2007030565
MO
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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