Individual provider · Type 1 NPI

Johnie M. Kelly Jr., CACMT

Massage Therapist · Los Altos, CA

NPI number 1043809023 Active

Practice location

895 Sherwood Ave Ste 101
Los Altos, CA 94022-1344

Call (650) 810-6582 Map

Mailing address

171 Hamilton Ave
Mountain View, CA 94043-4204

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X1148 (CA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1043809023

Johnie M. Kelly Jr., CACMT's National Provider Identifier is 1043809023, issued on Jan 13, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Los Altos, CA. The record was last updated on Jan 13, 2021.