Individual
SHANTEL MARGRIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
7971 BOLT DR SE, ADA, MI 49301-9391
(616) 209-2082
Mailing address
7971 BOLT DR SE, ADA, MI 49301-9391
(616) 209-2082
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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