Individual
MRS. KELLY GRACE GRAMKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
401 N MAIN ST, LAURIE, MO 65037-6173
(573) 374-0767
(573) 374-1399
Mailing address
10843 MCCASLAND RD, VERSAILLES, MO 65084-5652
(573) 378-7140
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2001002512
MO
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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