Individual
ZEKE MICHAEL MCNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1417 E COLTER ST APT 15, PHOENIX, AZ 85014-3052
(480) 208-4733
Mailing address
1417 E COLTER ST APT 15, PHOENIX, AZ 85014-3052
(480) 208-4733
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-18091
AZ
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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