Individual
KELLY MARIE BRAGGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
375 E MAIN ST STE 7, BAY SHORE, NY 11706-8418
(631) 343-4184
(631) 343-4168
Mailing address
254 SEAMAN AVE APT D4, NEW YORK, NY 10034-1285
(917) 856-1438
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009649-1
NY
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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