Individual
MRS. KRISTY J ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
3212 CENTENNIAL OAK CT, CLIO, MI 48420-2900
(810) 687-0941
Mailing address
3212 CENTENNIAL OAK CT, CLIO, MI 48420-2900
(810) 687-0941
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MASSAGE THERAPIST
MI
Other
Enumeration date
01/28/2007
Last updated
07/08/2007
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