Individual
KELLY L REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 N HARRISON AVE APT 2W, SAINT LOUIS, MO 63122-3969
(314) 303-3161
Mailing address
555 N HARRISON AVE APT 2W, SAINT LOUIS, MO 63122-3969
(314) 303-3161
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2006010875
MO
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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