Individual
JOHNNETTE DU RAND KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT, CMLDT
Contact information
Practice address
116 38TH ST, NEWPORT BEACH, CA 92663-2918
(949) 439-0282
Mailing address
116 38TH ST, NEWPORT BEACH, CA 92663-2918
(949) 439-0282
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23606
CA
Other
Enumeration date
10/04/2020
Last updated
10/04/2020
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