Individual
JO ELLEN SULLIVAN KANNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5747 W BROADWAY AVE STE 112, CRYSTAL, MN 55428-3881
(612) 205-3079
Mailing address
3542 GIRARD AVE N, MINNEAPOLIS, MN 55412-2418
(612) 205-3079
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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