Individual
KELLY DENISE MCLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT, RMT
Contact information
Practice address
7070 AUSTRIAN PINE WAY, #4, PORTAGE, MI 49024-3972
(269) 744-2107
Mailing address
7070 AUSTRIAN PINE WAY, #4, PORTAGE, MI 49024-3972
(269) 744-2107
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/17/2010
Last updated
02/03/2011
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