Individual
MRS. KELLY MARIE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
3010 WILSON AVE SW, GRANDVILLE, MI 49418-1242
(616) 249-8141
(616) 249-8147
Mailing address
3010 WILSON AVE SW, GRANDVILLE, MI 49418-1242
(616) 249-8141
(616) 249-8147
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501003433
MI
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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